Individual
DR. JILL MARIE HASTINGS-STORER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
104 LAKE POINT DR, CARROLLTON, GA 30117-1930
(770) 214-0470
Mailing address
104 LAKE POINT DR, CARROLLTON, GA 30117-1930
(770) 214-0470
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
841
GA
Other
Enumeration date
12/11/2009
Last updated
12/11/2009
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