Individual
EDRA LATRELLE FAUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
6311 STRICKLAND ST, DOUGLASVILLE, GA 30134-1261
(678) 838-8333
Mailing address
6311 STRICKLAND ST, DOUGLASVILLE, GA 30134-1261
(678) 838-8333
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC008879
GA
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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