Individual
MISS NIESHA FAVORS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1919 AKRON DR SE, ATLANTA, GA 30315-7001
(470) 754-8691
Mailing address
1919 AKRON DR SE, ATLANTA, GA 30315-7001
(404) 449-8511
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CO144448
GA
Other
Enumeration date
04/30/2025
Last updated
04/15/2026
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