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Organization
INNERVIEW, LLC
Active
Organization
INNERVIEW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMYA ESHE HODARI LPC (LICENSED PROFESSIONAL COUNSELOR)
(404) 433-9068
Entity
Organization
Contact information
Practice address
1640 POWERS FERRY RD SE STE 200, MARIETTA, GA 30067-5491
(404) 433-9068
Mailing address
3682 UTOY DR SW, ATLANTA, GA 30331-8617
(404) 433-9068
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC003074
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC003074
GEORGIA LICENSE
GA
Enumeration date
02/26/2018
Last updated
02/26/2018
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