Individual
AMELIA LIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1601 NORMAN DR APT L8, VALDOSTA, GA 31601-3224
(706) 978-2017
Mailing address
1601 NORMAN DR APT L8, VALDOSTA, GA 31601-3224
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC0015195
GA
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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