Provider Demographics
NPI:1013563212
Name:RALLINS, VEDA SONIA
Entity Type:Individual
Prefix:
First Name:VEDA
Middle Name:SONIA
Last Name:RALLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 STARR DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3622
Mailing Address - Country:US
Mailing Address - Phone:770-773-6445
Mailing Address - Fax:
Practice Address - Street 1:189 STARR DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3622
Practice Address - Country:US
Practice Address - Phone:770-773-6445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency