Individual
LISA BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1000 JOHNSON FERRY ROAD NE, ATLANTA, GA 30342-1611
(404) 851-6284
Mailing address
1000 JOHNSON FERRY ROAD NE, ATLANTA, GA 30342-1611
(404) 851-6284
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710387881
MEDICARE AND MEDICAID
GA
Enumeration date
08/26/2014
Last updated
10/22/2014
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