Individual
STEPHANIE RENEE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
100 CHURCHILL DR, JULIETTE, GA 31046-3840
(478) 320-3768
Mailing address
100 CHURCHILL DR, JULIETTE, GA 31046-3840
(478) 320-3768
(478) 202-7348
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
003174
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003174
LPC
GA
Enumeration date
10/06/2006
Last updated
05/10/2019
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