| At Your Service By Nicole | |
|
1440 Teaberry Cir Lawrenceville GA 30044-2123 | |
| (678) 727-8384 | |
| Not Available |
| Full Name | At Your Service By Nicole |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1440 Teaberry Cir, Lawrenceville, Georgia |
| Authorized Official Name and Position | Nicole N Jackson (OWNER) |
| Authorized Official Contact | 6787278384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| At Your Service By Nicole 1440 Teaberry Cir Lawrenceville GA 30044-2123 Ph: (678) 727-8384 | At Your Service By Nicole 1440 Teaberry Cir Lawrenceville GA 30044-2123 Ph: (678) 727-8384 |
| NPI Number | 1043961550 |
|---|---|
| Provider Enumeration Date | 01/16/2022 |
| Last Update Date | 01/16/2022 |
| Certification Date | 01/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043961550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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