| Interconnection Wellness Llc | |
|
113 S Perry St Ste 206 Lawrenceville GA 30046-4811 | |
| (470) 326-6717 | |
| Not Available |
| Full Name | Interconnection Wellness Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 113 S Perry St Ste 206, Lawrenceville, Georgia |
| Authorized Official Name and Position | Kristal Alexis Lewis (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4703690957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interconnection Wellness Llc 113 S Perry St Suite 206 #9320 Lawrenceville GA 30046-4811 Ph: (470) 369-0957 | Interconnection Wellness Llc 113 S Perry St Ste 206 Lawrenceville GA 30046-4811 Ph: (470) 326-6717 |
| NPI Number | 1780462473 |
|---|---|
| Provider Enumeration Date | 09/15/2023 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780462473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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