Organization
GRANDMA'S PORCH FAMILY SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIETRA TAYLOR LPC (OWNER)
(678) 607-5735
Entity
Organization
Contact information
Practice address
3915 CASCADE RD SW, SUITE T132, ATLANTA, GA 30331-8512
(678) 607-5735
Mailing address
1466 COPELAND AVE SW, ATLANTA, GA 30310-2501
(202) 250-9420
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006401
GA
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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