Individual
MRS. MARY LOU KONSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10950 STROUP RD, ROSWELL, GA 30075-2218
(770) 640-6274
(770) 640-6278
Mailing address
10950 STROUP RD, ROSWELL, GA 30075-2218
(770) 640-6274
(770) 640-6278
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
005078
GA
Other
Enumeration date
08/09/2008
Last updated
08/09/2008
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