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General NPI Number Information
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NPI Number | 1952618423
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Entity Type | Individual
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Provider Name | PATRICIA ANN BRANNON LICENSED CHRISTIAN C
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Gender | Female
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 5976 PEACHTREE RD
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City | ATLANTA
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State | GA
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Zip | 30341
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Country | US
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Telephone | 770-274-1010
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Fax | 770-274-1020
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Provider Business Mailing Address
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Address Line | 840 MORNING CREEK LN
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City | SUWANEE
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State | GA
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Zip | 30024-3790
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Country | US
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Telephone | 404-723-8667
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Fax | 770-274-1020
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 03983449
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License Number State | GA
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