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General NPI Number Information
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NPI Number | 1487020384
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Entity Type | Organization
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Legal Business Name | GARDEN PATCH COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 08/13/2015
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Provider Practice Location 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 | 864-539-2377
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82894
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City | HAPEVILLE
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State | GA
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Zip | 30354-0894
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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 | OWNER
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Name | ZANETA WILLIS
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Credential | LPC
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Telephone | 478-320-8014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC007903
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License Number State | GA
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