Individual
MS. KIMBERLY WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2852 JOHNSON FERRY RD STE 100, MARIETTA, GA 30062-5686
(404) 906-9831
Mailing address
2852 JOHNSON FERRY RD STE 100, MARIETTA, GA 30062-5686
(404) 906-9831
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008384
GA
Other
Enumeration date
04/29/2015
Last updated
11/24/2023
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