Doctor Name: | TAMI C PENNINGTON |
NPI Number: | 1245572973 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC007223 |
Business Practice Address: | 200 Resource Ln Winder, GA - 306808361 |
Business Phone Number: | 7707332705 |
Business Fax Number: | |
Mailing Address: | 200 Resource Lane, WINDER |
State: | GA |
Postal Code: | 30680 |
Phone Number: | 7707332705 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2013 |
NPI Last Update Date: | 11/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC007223 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |