Laquanda Jefferson

NPI #1104340256 in Lithia Springs, Georgia

Provider Information

NPI Number: 1104340256
Entity Type: Individual
Name: Laquanda Jefferson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jul 31, 2017
Last Updated: Jul 31, 2017

Practice Location

Address: 870 CRESTMARK DR STE 103
City: Lithia Springs
State: Georgia
ZIP Code: 30122-2665
Phone: (770) 672-0376

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X
Marriage & Family Therapist	106H00000X
Behavior Technician	106S00000X
Case Manager/Care Coordinator	171M00000X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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