Individual
LANEATRIA LYNN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT, CHES
Contact information
Practice address
2551 CLOUD LN, DECATUR, GA 30034-2253
(404) 536-0864
Mailing address
PO BOX 467102, ATLANTA, GA 31146-7102
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
183700000X
Pharmacy Technician
—
—
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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