Individual
KIMYATTA GREATHOUSE FAILS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,NCC,CAC
Contact information
Practice address
9505 COLLETON PL, MONTGOMERY, AL 36117-8436
(706) 442-5372
Mailing address
7806 VAUGHN RD, MONTGOMERY, AL 36116-1333
(334) 413-4055
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6140
CO
101YM0800X
Mental Health Counselor
17750
NC
101YP2500X
Professional Counselor
3375
AL
101YP2500X
Professional Counselor
Primary
3689
CO
101YP2500X
Professional Counselor
76321
TX
101YP2500X
Professional Counselor
8637
ID
Other
Enumeration date
05/08/2008
Last updated
09/17/2024
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