MEDICARE: MS. MARTY BRIGGS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC002908	GA

General Provider Information

NPI Number	:	1558376806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARTY BRIGGS LPC

Provider Business Mailing Address
First Line	:	560 HARBOR LN NW
Second Line	:
City	:	SUGAR VALLEY
State	:	GA
Zip	:	30746-5004
Country	:	US
Telephone Number	:	706-629-0373
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 CURTIS PKWY NE
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30701-2062
Country	:	US
Telephone Number	:	706-602-4484
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	07/08/2007

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