Doctor Name: | MRS. DANA MICHELLE NUMMERDOR |
NPI Number: | 1144425307 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LPC, NCC |
License Number: | LPC004927 |
Business Practice Address: | 514 W Bankhead Hwy Suite 100 Villa Rica, GA - 301801736 |
Business Phone Number: | 6789413868 |
Business Fax Number: | 6789413217 |
Mailing Address: | 514 W Bankhead Hwy, Suite 100 VILLA RICA |
State: | GA |
Postal Code: | 301801736 |
Phone Number: | 6789413868 |
Fax Number: | 6789413217 |
NPI Enumeration Date: | 06/18/2007 |
NPI Last Update Date: | 05/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC004927 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |