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General NPI Number Information
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NPI Number | 1962857565
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Entity Type | Organization
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Legal Business Name | DADDYSGIRL4EVER COUNSELING & COACHING EMPOWERMENT SERVICES INC.
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 1755 N BROWN RD SUITE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8198
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Country | US
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Telephone | 678-235-5912
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Fax | 404-443-0922
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Provider Business Mailing Address
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Address Line | 1755 N BROWN RD SUITE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8198
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Country | US
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Telephone | 678-235-5912
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Fax | 404-443-0922
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. SHANTREIS EDWARDS
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Credential | LPC
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Telephone | 646-251-6713
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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 | LPC008467
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License Number State | GA
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