Doctor Name: | DOUGLAS E SILLS |
NPI Number: | 1164658183 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC# 004634 |
License Number: | LPC 004634 |
Business Practice Address: | 150a Johnson St Dahlonega, GA - 305330501 |
Business Phone Number: | 7068646822 |
Business Fax Number: | |
Mailing Address: | 4331 Thurmon Tanner Rd, FLOWERY BRANCH |
State: | GA |
Postal Code: | 305422829 |
Phone Number: | 6785135700 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2009 |
NPI Last Update Date: | 06/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC 004634 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |