| Mintfour Change, Llc | |
|
6886 Main St Ste 215 Lithonia GA 30058-4508 | |
| (678) 526-1132 | |
| (678) 526-1153 |
| Full Name | Mintfour Change, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 6886 Main St Ste 215, Lithonia, Georgia |
| Authorized Official Name and Position | Joyce Davis Minter (MANAGING MEMBER) |
| Authorized Official Contact | 6785261132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mintfour Change, Llc 6886 Main St Ste 215 Lithonia GA 30058-4508 Ph: (678) 526-1132 | Mintfour Change, Llc 6886 Main St Ste 215 Lithonia GA 30058-4508 Ph: (678) 526-1132 |
| NPI Number | 1962678540 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 05/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962678540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC004278 (Georgia) | Primary |
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