Individual
KATHERYN D. MCDONELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNS-BC
Contact information
Practice address
110 DAWN DRIVE, FAYETTEVILLE, GA 30215
(770) 461-8882
Mailing address
110 DAWN DRIVE, FAYETTEVILLE, GA 30215
(770) 461-8882
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC1247
GA
101YM0800X
Mental Health Counselor
Primary
RN028740
GA
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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