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TEQUILA OLIVIA BANKS LPC

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

Registrant NPI Number: 1013517465

Individual Registrant:
 TEQUILA OLIVIA BANKS LPC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
8303 DUNLEAF ARC WAY NW  NORCROSS, GA 30093 US
Tel: 470-658-8156  Fax: --

Contact information for business:
8303 DUNLEAF ARC WAY NW  NORCROSS, GA 30093 US
Tel: 470-658-8156  Fax: --

Registration Information:
NPI: 1013517465
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
GALPC0011830

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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