Doctor Name: | MISS MARCIA D JONES |
NPI Number: | 1114166600 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., NCC, LPC |
License Number: | LPC004964 |
Business Practice Address: | 3557 Main St College Park, GA - 303372624 |
Business Phone Number: | 4049927132 |
Business Fax Number: | |
Mailing Address: | 10 Wilson Rd, STOCKBRIDGE |
State: | GA |
Postal Code: | 302814468 |
Phone Number: | 7705069575 |
Fax Number: | 7705069369 |
NPI Enumeration Date: | 02/06/2009 |
NPI Last Update Date: | 02/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC004964 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |