Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC005606 | GA |
NPI | 1003097072 |
---|---|
Provider Name | Mrs. Ruth Frances Cantor |
First Address | Senoia, GA 30276-3091 |
Second Address | Senoia, GA 30276-3091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2007 |
Last Update Date | 08/11/2012 |