Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC003283 | GA |
NPI | 1003804758 |
---|---|
Provider Name | Mrs. Christy Hall Wages |
First Address | Lawrenceville, GA 30045-5603 |
Second Address | Lawrenceville, GA 30045-5603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2005 |
Last Update Date | 08/07/2007 |