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Individual

MR. JERRELL WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
2090 SUGARLOAF PKWY STE 115, LAWRENCEVILLE, GA 30045-9402
(770) 658-4833
Mailing address
2090 SUGARLOAF PKWY STE 115, LAWRENCEVILLE, GA 30045-9402
(770) 676-0589

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
007754
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003153183B
GA
Enumeration date
10/08/2014
Last updated
12/23/2022
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