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General NPI Number Information
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NPI Number | 1750895785
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Entity Type | Individual
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Provider Name | EMILY GRACE MINDAY MA, APC, CCTP
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Gender | Female
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 4343 SHALLOWFORD ROAD BUILDING C SUITE 1 LOWER LEVEL
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City | MARIETTA
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State | GA
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Zip | 30062
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Country | US
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Telephone | 678-267-6170
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Fax |
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Provider Business Mailing Address
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Address Line | 4316 ARBOR LANDING DR
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City | MARIETTA
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State | GA
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Zip | 30066-2250
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Country | US
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Telephone | 678-267-6170
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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 | APC004695
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License Number State | GA
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