Individual
LASARA BELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-2937
(404) 712-2000
Mailing address
12 EXECUTIVE PARK DR NE, ATLANTA, GA 30329-2206
(404) 727-6143
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16047
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/05/2023
Last updated
06/14/2024
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