Healthcare Provider Details

I. General information

NPI: 1386552263
Provider Name (Legal Business Name): NOUR AGAPE INTEGRATIVE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10908 MORNING DOVE DR
HAMPTON GA
30228-2659
US

IV. Provider business mailing address

10908 MORNING DOVE DR
HAMPTON GA
30228-2659
US

V. Phone/Fax

Practice location:
  • Phone: 404-663-7324
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ASHTON MARSHALL
Title or Position: CLINICIAN
Credential: MFT
Phone: 404-663-7324