Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LPC003554 | GA |
N | 101YP2500X | Professional Counselor | LPC003554 | GA |
N | 101YS0200X | School Counselor | LPC003554 | GA |
NPI | 1245378306 |
---|---|
Provider Name | Dr. Sonya Marnique Anderson |
First Address | Atlanta, GA 30311-0251 |
Second Address | Atlanta, GA 30311-3233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LPC003554 | (02) | GA |