Most Relevant Information
Provider Data
| NPI Number: | 1003055104 |
| Provider Name: | LASHAWN FAISON-BRADLEY LPC, PSY.D |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | NONE |
Most Important Dates
| Enumeration Date: | 02/12/2009 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
44 DARBYS CROSSING DR STE 202
HIRAM
GA
301416008
Practice Location Phone/Fax
| Phone: | 4049076635 |
| Fax: |
Provider Mailing Location
8332 OFFICE PARK DR
SUITE H
DOUGLASVILLE
GA
301346937
Provider Mailing Phone/Fax
| Phone: | 4049076635 |
| Fax: |