Individual
MRS. JYLISE LOVELLE MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
632 FIELD CLIFF DR, STONE MOUNTAIN, GA 30087-4908
(404) 518-9028
Mailing address
632 FIELD CLIFF DR, STONE MOUNTAIN, GA 30087-4908
(404) 518-9028
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
006167
GA
Other
Enumeration date
04/12/2011
Last updated
04/12/2011
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