Organization
EDLYN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR T GRIMES (DIRECTOR)
(800) 540-9963
Entity
Organization
Contact information
Practice address
1880 BRASELTON HWY # 118-5174, LAWRENCEVILLE, GA 30043-2852
(470) 460-5568
Mailing address
3267 WATSON MEADOW LN, LOGANVILLE, GA 30052-8297
(718) 747-9494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/03/2020
Last updated
08/02/2022
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