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Organization
FANCY MESSY, LLC
Active
Organization
FANCY MESSY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN PETRO LPC, NCC (OWNER)
(585) 955-3655
Entity
Organization
Contact information
Practice address
4812 TECHNOLOGY DR BLDG 1, AUGUSTA, GA 30907-3912
(762) 218-3794
Mailing address
725 SOUTHWICK AVE, GROVETOWN, GA 30813-4278
(585) 955-3655
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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