Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1978 | GA |
Y | 101YM0800X | Mental Health Counselor | LPC010751 | GA |
N | 101YP1600X | Pastoral Counselor | GA |
NPI | 1154787943 |
---|---|
Provider Name | Theresa Hamlin |
First Address | Greenville, GA 30222-1514 |
Second Address | Greenville, GA 30222-1514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2016 |
Last Update Date | 11/03/2021 |