| Cora Lee Institute | |
|
3080 Highlands Pkwy Se Ste A Smyrna GA 30082-5181 | |
| (770) 634-2349 | |
| (770) 941-9919 |
| Full Name | Cora Lee Institute |
|---|---|
| Speciality | Psychologist |
| Location | 3080 Highlands Pkwy Se, Smyrna, Georgia |
| Authorized Official Name and Position | Tywanda Ellison Lightfoot (OWNER) |
| Authorized Official Contact | 7706342349 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cora Lee Institute 3080 Highlands Pkwy Se Ste A Smyrna GA 30082-5181 Ph: (770) 634-2349 | Cora Lee Institute 3080 Highlands Pkwy Se Ste A Smyrna GA 30082-5181 Ph: (770) 634-2349 |
| NPI Number | 1083953178 |
|---|---|
| Provider Enumeration Date | 02/08/2013 |
| Last Update Date | 02/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083953178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY003343 (Georgia) | Primary |
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