Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LPC005043 | GA |
NPI | 1003070913 |
---|---|
Provider Name | Stephanie Leoni |
First Address | Alpharetta, GA 30023-0492 |
Second Address | Alpharetta, GA 30023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 03/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LPC005043 | LICENSE # (01) | GA |