Organization
LOVEWELL COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY RADFORD LPC (OWNER)
(678) 977-9694
Entity
Organization
Contact information
Practice address
1507 HURT RD SW, MARIETTA, GA 30008-5815
(678) 977-9694
Mailing address
1358 VELVET CREEK WAY SW, MARIETTA, GA 30008-7624
(615) 497-4748
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/22/2019
Last updated
11/22/2019
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