LYCHANNEL TICOLE HEAD

MCDONOUGH, GA
NPI1871163097
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy174400000X Specialist
(Licence: GA  1952405052)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: GA  F06211529)
Enumeration Date2021-06-29
Last Update Date2026-01-12
Business Address
LYCHANNEL TICOLE HEAD
1631 HIGHWAY 20 W
MCDONOUGH, GA 30253-7311
Phone number: 770-288-2822
Mailing Address
LYCHANNEL TICOLE HEAD
1631 HIGHWAY 20 W
MCDONOUGH, GA 30253-7311
Phone number: 770-288-2822