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1689420424
LEASA LASAE BLACKMON
ATHENS, GA
NPI
1689420424
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: GA 221219)
Enumeration Date
2024-04-24
Last Update Date
2024-04-24
Business Address
LEASA LASAE BLACKMON RN
240 MITCHELL BRIDGE RD
ATHENS, GA 30606-2043
Phone number: 770-910-9196
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Mailing Address
LEASA LASAE BLACKMON RN
PO BOX 490182
LAWRENCEVILLE, GA 30049-0004
Phone number: 470-232-5119
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