Provider Demographics
NPI:1437985512
Name:GEORGE, LYNN MARIAM
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIAM
Last Name:GEORGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 CHRIS LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3340
Mailing Address - Country:US
Mailing Address - Phone:678-356-7005
Mailing Address - Fax:
Practice Address - Street 1:1395 CHRIS LAKE DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3340
Practice Address - Country:US
Practice Address - Phone:678-356-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical