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General NPI Number Information
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NPI Number | 1053067942
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Entity Type | Individual
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Provider Name | TAWONDA MARIA HUNTER EDD, NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 709 BREEDLOVE DR
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City | MONROE
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State | GA
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Zip | 30655
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Country | US
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Telephone | 762-207-4340
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Fax |
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Provider Business Mailing Address
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Address Line | 2483 HERITAGE VLG STE 16-302
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City | SNELLVILLE
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State | GA
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Zip | 30078-6140
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC012768
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License Number State | GA
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