Healthcare Provider Details

I. General information

NPI: 1932114675
Provider Name (Legal Business Name): LAWANDA HOPE HUFFMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MARTIN LUTHER KING JR DR SW SUITE 277
ATLANTA GA
30303-3536
US

IV. Provider business mailing address

1979 RESTING CREEK DR
DECATUR GA
30035-2215
US

V. Phone/Fax

Practice location:
  • Phone: 404-730-0230
  • Fax: 404-730-0341
Mailing address:
  • Phone: 404-730-0230
  • Fax: 404-730-0341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC003964
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: