| Marvelously Adorned, Llc | |
|
470 Commerce Dr Ste 538 Peachtree City GA 30269-3517 | |
| (404) 594-3857 | |
| (404) 777-9348 |
| Full Name | Marvelously Adorned, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 470 Commerce Dr Ste 538, Peachtree City, Georgia |
| Authorized Official Name and Position | Lashanda L Edwards (THERAPIST/CLINICAN/COUNSELOR) |
| Authorized Official Contact | 4045943857 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marvelously Adorned, Llc Po Box 84 Tyrone GA 30290-0084 Ph: (404) 594-3857 | Marvelously Adorned, Llc 470 Commerce Dr Ste 538 Peachtree City GA 30269-3517 Ph: (404) 594-3857 |
| NPI Number | 1023521473 |
|---|---|
| Provider Enumeration Date | 11/08/2017 |
| Last Update Date | 01/24/2022 |
| Certification Date | 01/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023521473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | CSW005680 (Georgia) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW005680 (Georgia) | Primary |
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