Individual
MRS. LATERIA NICOLE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, NCC
Contact information
Practice address
2302 DAWSON ROAD, SUITE 102, ALBANY, GA 31707
(229) 329-1580
Mailing address
PO BOX 491, LEESBURG, GA 31763-0491
(229) 269-6821
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC014557
GA
101YP2500X
Professional Counselor
Primary
LPC014557
GA
Other
Enumeration date
10/29/2020
Last updated
01/13/2025
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