MEDICARE: LAURA ANNE LIM SANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1528856895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ANNE LIM SANG

Provider Business Mailing Address
First Line	:	3613 BLACKWELL RUN
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-2866
Country	:	US
Telephone Number	:	678-665-5099
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CHURCHILL CT STE 106
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-6882
Country	:	US
Telephone Number	:	678-665-5099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	04/28/2025

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Directions to “ LAURA ANNE LIM SANG ” Practice Location

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