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Individual

KATHY MALCOLM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4751 CHERRING DR, DUNWOODY, GA 30338-5244
(678) 687-5357
Mailing address
4751 CHERRING DR, DUNWOODY, GA 30338-5244
(678) 687-5357

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1890
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1890
LPC
GA
Enumeration date
03/18/2014
Last updated
03/18/2014
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