| Brain And Soul Wellness Group, Llc | |
|
3050 Five Forks Trickum Rd Sw Ste D451 Lilburn GA 30047-1810 | |
| (214) 280-0848 | |
| Not Available |
| Full Name | Brain And Soul Wellness Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3050 Five Forks Trickum Rd Sw Ste D451, Lilburn, Georgia |
| Authorized Official Name and Position | Maloa Chu Affuembey (OWNER/MD) |
| Authorized Official Contact | 4044360677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brain And Soul Wellness Group, Llc 3050 Five Forks Trickum Rd Sw Ste D451 Lilburn GA 30047-1810 Ph: () - | Brain And Soul Wellness Group, Llc 3050 Five Forks Trickum Rd Sw Ste D451 Lilburn GA 30047-1810 Ph: (214) 280-0848 |
| NPI Number | 1871120659 |
|---|---|
| Provider Enumeration Date | 03/24/2020 |
| Last Update Date | 05/25/2020 |
| Certification Date | 05/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871120659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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