Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | LPC008846 | GA |
Y | 101YP2500X | Professional Counselor | LPC008846 | GA |
NPI | 1053867911 |
---|---|
Provider Name | Ms. Diane Orado |
First Address | Cumming, GA 30040-2664 |
Second Address | Cumming, GA 30040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2016 |
Last Update Date | 12/11/2019 |