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NPI Profile for LIGHTHOUSE COUNSELING PC in NEWNAN, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Clinical |
103TC0700X | 62 | Psychologist, Clinical |
| NPI Number | 1205961232 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/22/2007 | |
| Last updated | 07/24/2007 - About 19 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LIGHTHOUSE COUNSELING PC
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LIGHTHOUSE COUNSELING PC