Individual
MS. LYDIA THREATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
1710 HIGHWAY 16 W, GRIFFIN, GA 30223-7107
(770) 229-3407
(770) 229-3465
Mailing address
1710 HIGHWAY 16 W, GRIFFIN, GA 30223-7107
(770) 229-3407
(770) 229-3465
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC006571
GA
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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