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General NPI Number Information
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NPI Number | 1033976501
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Entity Type | Individual
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Provider Name | LAN CHEN
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 3200 POINTE PKWY, SUITE 400, PEACHTREE CORNERS
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City | NORCROSS
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State | GA
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Zip | 30092
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Country | US
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Telephone | 678-259-9298
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Fax |
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Provider Business Mailing Address
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Address Line | 10090 GRANDVIEW SQ
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City | JOHNS CREEK
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State | GA
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Zip | 30097-2541
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Country | US
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Telephone | 167-868-7778
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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