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Individual

KEYEARA MONA ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4271 S LEE ST, 101 & 102, BUFORD, GA 30518-3710
(678) 765-8160
Mailing address
4271 S LEE ST, 101 & 102, BUFORD, GA 30518-3710
(678) 765-8160

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN093043
GA

Other

Enumeration date
01/13/2017
Last updated
01/13/2017
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