NPI age
19 years
Enumerated 2007-05-07
Across 7547 active counselor providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | LPC004744 | LICENSED PROF. COUNSELOR |
| 01 (GA) | 172615 | PSY. REHAB. (CPRP) |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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