Doctor Name: | STEPHANIE MAYER |
NPI Number: | 1043604671 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LAPC |
License Number: | APC003466 |
Business Practice Address: | 2060 Dan Proctor Dr Saint Marys, GA - 315583894 |
Business Phone Number: | 9126739909 |
Business Fax Number: | |
Mailing Address: | 4252 Inverness Rd, DULUTH |
State: | GA |
Postal Code: | 300964276 |
Phone Number: | 7708422522 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2015 |
NPI Last Update Date: | 03/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | APC003466 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |