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General NPI Number Information
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NPI Number | 1366946154
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Entity Type | Individual
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Provider Name | AMMERETA LEANNA GASKIN LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 275 COUNTRY CLUB DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7349
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Country | US
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Telephone | 770-474-8400
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Fax | 770-474-3738
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Provider Business Mailing Address
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Address Line | 275 COUNTRY CLUB DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7349
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Country | US
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Telephone | 770-474-8400
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Fax | 770-474-3738
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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 | MFT001556
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2298
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License Number State | NC
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