MEDICARE: LASHELL R POPE

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	106H00000X	Marriage & Family Therapist	001615	GA

General Provider Information

NPI Number	:	1992246151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHELL R POPE

Provider Business Mailing Address
First Line	:	64 ASPEN WAY
Second Line	:
City	:	DALLAS
State	:	GA
Zip	:	30157-7141
Country	:	US
Telephone Number	:	678-697-7982
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 ASPEN WAY
Second Line	:
City	:	DALLAS
State	:	GA
Zip	:	30157-7141
Country	:	US
Telephone Number	:	678-697-7982
Fax Number	:

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

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	07/25/2023

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Directions to “ LASHELL R POPE ” Practice Location

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