Provider Demographics
NPI:1891963211
Name:MCRAE, TARAJI KEYA (DC)
Entity Type:Individual
Prefix:DR
First Name:TARAJI
Middle Name:KEYA
Last Name:MCRAE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9002 GARDNER DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-2193
Mailing Address - Country:US
Mailing Address - Phone:678-478-6324
Mailing Address - Fax:770-753-9152
Practice Address - Street 1:3502 OLD MILTON PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4458
Practice Address - Country:US
Practice Address - Phone:678-879-4242
Practice Address - Fax:678-879-5411
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007895111N00000X
NC3383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor