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General NPI Number Information
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NPI Number | 1760006035
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Entity Type | Organization
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Legal Business Name | HEALTHY CONNECTIONS COUNSELING
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 06/03/2020
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Provider Practice Location Address
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Address Line | 4434 COLUMBIA RD STE 202
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City | MARTINEZ
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State | GA
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Zip | 30907-4271
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Country | US
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Telephone | 706-810-2057
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Fax | 706-810-2057
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Provider Business Mailing Address
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Address Line | 4434 COLUMBIA RD STE 202
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City | MARTINEZ
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State | GA
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Zip | 30907-4271
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Country | US
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Telephone | 706-810-2057
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Fax | 706-810-2057
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Authorized Official
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Title or Position | LPC
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Name | MRS. TANYA LORENZI
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Credential | LPC
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Telephone | 706-810-2057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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