Organization
AXIS HOPE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRICE LEE (BILLER)
(404) 947-1081
Entity
Organization
Contact information
Practice address
2551 ROSWELL RD STE 420, MARIETTA, GA 30062-4761
(678) 648-7888
Mailing address
2551 ROSWELL RD STE 420, MARIETTA, GA 30062-4761
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
20130228
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
20171710
MD
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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