Provider Demographics
NPI:1134830094
Name:MAY, ROSHANDA CAMILLE
Entity type:Individual
Prefix:MRS
First Name:ROSHANDA
Middle Name:CAMILLE
Last Name:MAY
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 1:409 ELHAM LN
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-5858
Mailing Address - Country:US
Mailing Address - Phone:678-507-6808
Mailing Address - Fax:
Practice Address - Street 1:7910 MALL RING RD
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-7000
Practice Address - Country:US
Practice Address - Phone:404-585-7533
Practice Address - Fax:678-825-2665
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008556101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional