Healthcare Provider Details

I. General information

NPI: 1528988417
Provider Name (Legal Business Name): JENNIFER LASHAY ORR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2759 DELK RD SE STE 1622
MARIETTA GA
30067-8887
US

IV. Provider business mailing address

2759 DELK RD SE STE 1622
MARIETTA GA
30067-8887
US

V. Phone/Fax

Practice location:
  • Phone: 678-268-0445
  • Fax:
Mailing address:
  • Phone: 678-268-0445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: