Individual
MS. ANA LYLLIAN GUADALUPE MENJIVAR-COUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
840 LAKE CONNIE RD, CARROLLTON, GA 30116-9783
(770) 853-7991
Mailing address
840 LAKE CONNIE RD, CARROLLTON, GA 30116-9783
(770) 853-7991
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
APC0005348
GA
101YP2500X
Professional Counselor
Primary
LPC014193
GA
101YS0200X
School Counselor
793694
GA
Other
Enumeration date
08/03/2018
Last updated
12/20/2024
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