| Play Wellness Llc | |
|
3545 Broad St # 80742 Atlanta GA 30341-2259 | |
| (770) 375-8124 | |
| Not Available |
| Full Name | Play Wellness Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3545 Broad St # 80742, Atlanta, Georgia |
| Authorized Official Name and Position | Yolanda Fountain (OWNER) |
| Authorized Official Contact | 6788719355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Play Wellness Llc 3545 Broad St # 80742 Atlanta GA 30341-2259 Ph: () - | Play Wellness Llc 3545 Broad St # 80742 Atlanta GA 30341-2259 Ph: (770) 375-8124 |
| NPI Number | 1689072068 |
|---|---|
| Provider Enumeration Date | 12/16/2014 |
| Last Update Date | 06/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689072068 | NPI | - | NPPES |
| 003155496A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC006900 (Georgia) | Primary |
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