NPI 1871120659
Brain and Soul Wellness Group, LLC
Practice location
- Address
- 3050 Five Forks Trickum Rd SW STE D451, Lilburn, GA 30047-1810
- Phone
- (214) 280-0848
Authorised official
- Name
- Maloa Chu Affuembey
- Title
- Owner/Md
- Phone
- (404) 436-0677
Registered specialties
Psychiatry Physician
Primary
Registry record
- NPI
- 1871120659
- Entity type
- Organization
- NPI issued
- 24 Mar 2020
- Record last updated
- 25 May 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.