Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | APC007190 | GA |
NPI | 1003427782 |
---|---|
Provider Name | Debbie Weitz |
First Address | Marietta, GA 30062-8317 |
Second Address | Marietta, GA 30062-8317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2020 |
Last Update Date | 14/08/2020 |