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General NPI Number Information
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NPI Number | 1699539304
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Entity Type | Organization
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Legal Business Name | LANDMARK COUNSELING LLC
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 871 SEABREEZE LAKE RD
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City | BUCHANAN
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State | GA
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Zip | 30113-4474
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Country | US
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Telephone | 909-316-8813
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Fax | 909-751-1145
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Provider Business Mailing Address
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Address Line | 871 SEABREEZE LAKE RD
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City | BUCHANAN
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State | GA
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Zip | 30113-4474
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Country | US
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Telephone | 909-316-8813
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Fax | 909-751-1145
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Authorized Official
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Title or Position | CEO
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Name | MRS. TOKUNBO TOCEE SHOKUNBI HARMON
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Credential | MD
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Telephone | 404-610-6362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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