Individual
LAUREN COSTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(404) 727-5655
Mailing address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/17/2021
Last updated
03/25/2024
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