NPI 1619609310

Tiara Bracey

Practitioner Prevention Professional Riverdale, GA

Practice location

Address: 6071 Highway 85 APT 31a, Riverdale, GA 30274-1531
Phone: (678) 437-7350
Mailing address: 6691 Church St Unit 960843, Riverdale, GA 30296-4033

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 000000 (GA)

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Registry record

NPI: 1619609310
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jun 2022
Record last updated: 30 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.