Organization
BRAIN AND SOUL WELLNESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALOA CHU AFFUEMBEY MD (OWNER/MD)
(404) 436-0677
Entity
Organization
Contact information
Practice address
3050 FIVE FORKS TRICKUM RD SW STE D451, LILBURN, GA 30047-1810
(214) 280-0848
Mailing address
3050 FIVE FORKS TRICKUM RD SW STE D451, LILBURN, GA 30047-1810
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
05/25/2020
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