| Doctor Name: | MS. MARLA ROUNTREE |
| NPI Number: | 1366880601 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 007316 |
| Business Practice Address: | 1905 S Hutchinson Ave Adel, GA - 316205246 |
| Business Phone Number: | 2298964559 |
| Business Fax Number: | 2296716774 |
| Mailing Address: | 3120 N Oak Street Ext Ste C, VALDOSTA |
| State: | GA |
| Postal Code: | 316025910 |
| Phone Number: | 2296716100 |
| Fax Number: | 2296716774 |
| NPI Enumeration Date: | 06/10/2013 |
| NPI Last Update Date: | 06/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 007316 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |