Individual
KAYLA LUSTOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2675 MALL OF GEORGIA BLVD STE 102, BUFORD, GA 30519-8783
(470) 201-5717
Mailing address
145 PR SMITH BLVD, WINDER, GA 30680-8023
(404) 574-0359
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC015492
GA
Other
Enumeration date
11/22/2023
Last updated
09/04/2025
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