Doctor Name: | CHERYL DELUCA-JOHNSON |
NPI Number: | 1043677123 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC 004168 |
License Number: | LPC004168 |
Business Practice Address: | 2022 Forest Hill Ct Braselton, GA - 305174065 |
Business Phone Number: | 6783006297 |
Business Fax Number: | |
Mailing Address: | 2022 Forest Hill Ct, BRASELTON |
State: | GA |
Postal Code: | 305174065 |
Phone Number: | 6783006297 |
Fax Number: | |
NPI Enumeration Date: | 01/21/2016 |
NPI Last Update Date: | 01/21/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC004168 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |