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MARYAM CLYBURN LPC

Professional >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1992380281

Individual Registrant:
 MARYAM  CLYBURN LPC
Gender: F
Sole Proprietor

Location and contact information for practice:
1128 LAKEVIEW RD  GRAYSON, GA 30017-1143 US
Tel: 770-265-7076  Fax: --

Contact information for business:
1128 LAKEVIEW RD  GRAYSON, GA 30017-1143 US
Tel: 770-978-9393  Fax: --

Registration Information:
NPI: 1992380281
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
GALPC001868

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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