Individual
KEISHA L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S, NCC,LAPC
Contact information
Practice address
500 LANIER AVE W STE 103B, FAYETTEVILLE, GA 30214-7640
(404) 800-4002
Mailing address
6873 SLATE STONE WAY SE, MABLETON, GA 30126-5433
(404) 914-8005
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC007240
GA
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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