Healthcare Provider Details

I. General information

NPI: 1962330175
Provider Name (Legal Business Name): NAJAHLA YONELL ORLYN EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 COUNTRY CLUB DR STE 100DEF
STOCKBRIDGE GA
30281-9080
US

IV. Provider business mailing address

660 SEDONA LOOP
HAMPTON GA
30228-2406
US

V. Phone/Fax

Practice location:
  • Phone: 470-264-8599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: