Individual provider · Type 1 NPI

Laquanda Jefferson

Student in an Organized Health Care Education/Training Program · Lithia Springs, GA

NPI number 1104340256 Active

Practice location

870 Crestmark Dr Ste 103
Lithia Springs, GA 30122-2665

Call (770) 672-0376 Map

Fax (770) 672-0376

Mailing address

PO Box 5191
Douglasville, GA 30154-0004

Specialties and licenses

TaxonomyCodeLicense
Behavior Analyst 103K00000XNone listed
Marriage & Family Therapist 106H00000XNone listed
Behavior Technician 106S00000XNone listed
Case Manager/Care Coordinator 171M00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Another provider at this address

Other student in an organized health care education/training program providers in Lithia Springs

See all in Lithia Springs →

About NPI 1104340256

Laquanda Jefferson's National Provider Identifier is 1104340256, issued on Jul 31, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Lithia Springs, GA. The record was last updated on Jul 31, 2017.