Individual
MRS. MARIANELA MATHEUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,CPCS,RPT
Contact information
Practice address
2050 BEAUMONT LN, DUNWOODY, GA 30338-4500
(770) 351-9033
(770) 772-0355
Mailing address
2050 BEAUMONT LN, DUNWOODY, GA 30338-4500
(770) 351-9033
(770) 772-0355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
002525
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003200881A
—
GA
Enumeration date
05/21/2007
Last updated
10/16/2018
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