Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 10184220 | GA |
NPI | 1336755198 |
---|---|
Provider Name | Ms. Deborah Mae Adams |
First Address | Duluth, GA 30095-9517 |
Second Address | Lilburn, GA 30047-4507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2020 |
Last Update Date | 17/09/2020 |