Individual
AKIDA LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1524 GORDON BOW LN SW, MABLETON, GA 30126-2110
(770) 743-7037
(770) 743-7037
Mailing address
1524 GORDON BOW LN SW, MABLETON, GA 30126-2110
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC016148
GA
Other
Enumeration date
11/12/2025
Last updated
11/19/2025
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