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General NPI Number Information
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NPI Number | 1093322398
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Entity Type | Individual
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Provider Name | WENDY BARIBEAU LAMFT
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Gender | Female
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 4411 SUWANEE DAM RD SUITE 720
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City | SUWANEE
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State | GA
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Zip | 30024
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Country | US
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Telephone | 678-993-8494
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Fax |
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Provider Business Mailing Address
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Address Line | 5311 E COVE NE
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City | MARIETTA
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State | GA
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Zip | 30068
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Country | US
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Telephone | 561-596-1938
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT000527
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License Number State | GA
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