Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | GA | |
N | 101YP1600X | Pastoral Counselor | GA | |
N | 101YP2500X | Professional Counselor | GA |
NPI | 1053737668 |
---|---|
Provider Name | Miss Andrea Michelle Monday |
First Address | Eatonton, GA 31024-6458 |
Second Address | Eatonton, GA 31024-6458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2014 |
Last Update Date | 14/02/2016 |