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Individual

LOVELY IMASUEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1576 ATKINSON RD STE 212, LAWRENCEVILLE, GA 30043-5701
(918) 254-4937
Mailing address
1576 ATKINSON RD STE 212, LAWRENCEVILLE, GA 30043-5701

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
05/13/2024
Last updated
05/13/2024
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