Organization
AVENUES OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN SMOLKO-SELF 7707134574 (OWNER/LPC)
(770) 713-4574
Entity
Organization
Contact information
Practice address
1568 CLOVERDALE DR SE, MARIETTA, GA 30067-7406
(770) 713-4574
Mailing address
132 GALLERY COURT, ACWORTH, GA 30101
(770) 713-4574
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004657
GA
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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