DAPHENE ELIJAH

LITHIA SPRINGS, GA
NPI1053827501
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-12-20
Last Update Date2017-12-20
Business Address
DAPHENE ELIJAH LPN
870 CRESTMARK DR STE 203
LITHIA SPRINGS, GA 30122-2665
Phone number: 844-300-0102
Mailing Address
DAPHENE ELIJAH LPN
1649 BRICE RD STE C
REYNOLDSBURG, OH 43068-2796
Phone number: