Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 3453 | GA |
NPI | 1003091125 |
---|---|
Provider Name | Ms. Carol Braun Zepf |
First Address | Woodstock, GA 30189-8133 |
Second Address | Woodstock, GA 30189-8133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 08/01/2008 |