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General NPI Number Information
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NPI Number | 1972895316
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Entity Type | Organization
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Legal Business Name | IN THE ZONE FAMILY COUNSELING L.L.C.
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 917 ARLINGTON DR
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City | TUCKER
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State | GA
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Zip | 30084-1505
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Country | US
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Telephone | 770-315-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 917 ARLINGTON DR
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City | TUCKER
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State | GA
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Zip | 30084-1505
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Country | US
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Telephone | 770-315-3100
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. ABBE BRYER CONNELL
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Credential | LCSW
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Telephone | 770-315-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW003074
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License Number State | GA
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