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General NPI Number Information
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NPI Number | 1164792735
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Entity Type | Individual
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Provider Name | ZANETA WILLIS LAPC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 3590 COVINGTON HWY
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City | DECATUR
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State | GA
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Zip | 30032-1850
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Country | US
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Telephone | 404-687-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 2972 HAPEVILLE RD SW
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City | ATLANTA
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State | GA
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Zip | 30354-2008
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Country | US
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Telephone | 478-320-8014
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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 | APC003228
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APC003228
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License Number State | GA
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