Individual
CRYSTAL MARIE LILAVOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1899 POWERS FERRY RD SE, ATLANTA, GA 30339-5620
(239) 595-6803
Mailing address
2672 LAKEFIELD PASS, MARIETTA, GA 30064-5746
(239) 595-6803
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
313809
GA
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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