Individual
LAJUAN SPIVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8337 PARK DRIVE, DOUGLASVILLE, GA 30129
(678) 236-9876
Mailing address
5465 SKYVIEW DR SW, ATLANTA, GA 30331-7755
(404) 663-2773
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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