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Individual

MELANIE ANN DALLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
340 PINE CREST RD, JASPER, GA 30143-2662
(404) 808-7740
(706) 692-2091
Mailing address
340 PINE CREST RD, JASPER, GA 30143-2662
(404) 808-7740
(706) 692-2091

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003408
GA

Other

Enumeration date
06/30/2008
Last updated
06/30/2008
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