Individual
CONNIE J YOUNG-GIBRALTARIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, MA, LPC
Contact information
Practice address
950 EAGLES LANDING PKWY, SUITE 665, STOCKBRIDGE, GA 30281-7343
(510) 914-7540
(770) 629-2139
Mailing address
950 EAGLES LANDING PKWY, SUITE 665, STOCKBRIDGE, GA 30281-7343
(510) 914-7540
(770) 629-2139
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009420
GA
Other
Enumeration date
02/21/2017
Last updated
04/23/2017
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