Individual
MARISSA CHARLETT GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC, PMH-C
Contact information
Practice address
37 W FAIRMONT AVE STE 320, SAVANNAH, GA 31406-3458
(850) 217-4417
Mailing address
PO BOX 1431, POOLER, GA 31322-1277
(850) 217-4417
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC014137
GA
374J00000X
Doula
—
—
Other
Enumeration date
07/06/2021
Last updated
01/24/2024
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