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General NPI Number Information
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NPI Number | 1003775990
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Entity Type | Organization
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Legal Business Name | TRINITY INNOVATIVE SUPPORT
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Dates
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Enumeration Date | 01/17/2026
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 605 ATHENS HWY UNIT 5-201
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City | LOGANVILLE
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State | GA
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Zip | 30052-4767
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Country | US
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Telephone | 404-740-4910
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Fax |
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Provider Business Mailing Address
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Address Line | 605 ATHENS HWY UNIT 5-201 5-201
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City | LOGANVILLE
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State | GA
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Zip | 30052-4767
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Country | US
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Telephone | 404-740-4910
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TERESA SNOW
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Credential | LPC
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Telephone | 404-740-4910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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