Organization
MANNA SCHOLARSHIP FUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BURNETT PSYD (EXECUTIVE DIRECTOR)
(770) 495-9775
Entity
Organization
Contact information
Practice address
965 OAKLAND RD, STE 3E, LAWRENCEVILLE, GA 30044-3758
(770) 495-9775
Mailing address
965 OAKLAND RD, STE 3E, LAWRENCEVILLE, GA 30044-3758
(770) 495-9775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC008922
GA
251S00000X
Community/Behavioral Health Agency
LPC008922
GA
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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