| Edlyn Llc | |
|
1880 Braselton Hwy # 118-5174 Lawrenceville GA 30043-2852 | |
| (470) 460-5568 | |
| Not Available |
| Full Name | Edlyn Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1880 Braselton Hwy # 118-5174, Lawrenceville, Georgia |
| Authorized Official Name and Position | Victor T Grimes (DIRECTOR) |
| Authorized Official Contact | 8005409963 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edlyn Llc 3267 Watson Meadow Ln Loganville GA 30052-8297 Ph: (718) 747-9494 | Edlyn Llc 1880 Braselton Hwy # 118-5174 Lawrenceville GA 30043-2852 Ph: (470) 460-5568 |
| NPI Number | 1154935450 |
|---|---|
| Provider Enumeration Date | 09/03/2020 |
| Last Update Date | 08/02/2022 |
| Certification Date | 08/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154935450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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