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General NPI Number Information
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NPI Number | 1497021489
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Entity Type | Organization
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Legal Business Name | FAMILY GUIDANCE LLC
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Dates
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Enumeration Date | 03/24/2012
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Last Update Date | 03/24/2012
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Provider Practice Location Address
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Address Line | 2775 CRUSE RD SUITE 1601
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7140
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Country | US
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Telephone | 770-841-6312
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Fax |
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Provider Business Mailing Address
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Address Line | 2775 CRUSE RD SUITE 1601
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-7140
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Country | US
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Telephone | 770-841-6312
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANET M WARING
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Credential | LPC
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Telephone | 770-841-6312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 1398
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License Number State | GA
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