Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC003890 | GA |
NPI | 1003050105 |
---|---|
Provider Name | Mrs. Tameran Hinson |
First Address | Acworth, GA 30101-6875 |
Second Address | Acworth, GA 30101-6875 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2009 |
Last Update Date | 21/04/2009 |