Organization
MARVELOUSLY ADORNED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASHANDA L EDWARDS LCSW (THERAPIST/CLINICAN/COUNSELOR)
(404) 594-3857
Entity
Organization
Contact information
Practice address
470 COMMERCE DR STE 538, PEACHTREE CITY, GA 30269-3517
(404) 594-3857
(404) 777-9348
Mailing address
PO BOX 84, TYRONE, GA 30290-0084
(404) 594-3857
(404) 777-9348
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CSW005680
GA
1041C0700X
Clinical Social Worker
Primary
CSW005680
GA
Other
Enumeration date
11/08/2017
Last updated
01/24/2022
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