Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 101YP2500X- LPC00610 | GA |
N | 101YS0200X | School Counselor | 101YS0200X- 723411 | GA |
NPI | 1154618643 |
---|---|
Provider Name | Mr. Patrick T Mckay |
First Address | Villa Rica, GA 30180-3856 |
Second Address | Villa Rica, GA 30180-3856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 05/07/2011 |