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MARY KATHLEEN ALLEN LPC
Professional >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1518024504
Individual Registrant: MARY KATHLEEN ALLEN LPC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
5405 MEMORIAL DR STE D STONE MOUNTAIN, GA 30083-3236 US
Tel: 404-296-3800 Fax: 404-297-8753
Tel: 404-296-3800 Fax: 404-297-8753
Contact information for business:
5405 MEMORIAL DR STE D STONE MOUNTAIN, GA 30083-3236 US
Tel: 404-296-3800 Fax: 404-297-8753
Tel: 404-296-3800 Fax: 404-297-8753
Registration Information:
NPI: 1518024504
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor Professional | GA | LPC001196 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
