MEDICARE: ROLA DOUGHAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach		GA

General Provider Information

NPI Number	:	1902755887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROLA DOUGHAN

Provider Business Mailing Address
First Line	:	2138 GREENSWARD DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3635
Country	:	US
Telephone Number	:	404-630-6462
Fax Number	:

Provider Business Practice Location Address
First Line	:	2138 GREENSWARD DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3635
Country	:	US
Telephone Number	:	404-630-6462
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2026
Last Update Date	:	01/24/2026

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Directions to “ ROLA DOUGHAN ” Practice Location

Language	Start Address	Practice Location

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