is a Professional in Fayetteville, Georgia. practices all healthcare services and medical treatments related to Professional. The NPI Number for is 1689831448. The last update date is .
's current location address is 145 Governors Sq Ste A, Fayetteville, Georgia. You can contact this provider via phone number 6783641300 and fax number 6783641352. The mailing address for is 145 Governors Sq Ste A, Fayetteville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 145 Governors Sq Ste A, Fayetteville, Georgia |
| Phone Number | 6783641300 |
| Fax Number | 6783641352 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1689831448 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 145 Governors Sq Ste A |
|---|---|
| City | Fayetteville |
| State | Georgia (GA) |
| Post Code | 302154861 |
| Phone Number | 6783641300 |
| Fax Number | 6783641352 |
Provider's Primary Taxonomy Detail
| Speciality | Professional |
|---|---|
| Taxonomy | 101Yp2500X |
| Licence No | LPC003094 |
|
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 102214679 | GA | -- |
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