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Individual

ELOUISE LAMAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
445 WINN WAY, DECATUR, GA 30030-1707
(404) 294-3745
Mailing address
445 WINN WAY, DECATUR, GA 30030-1707

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009240
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13944751
CAQH
GA
Enumeration date
12/19/2016
Last updated
07/13/2017
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