Individual
KELLIE GWALTNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMFT, LPC
Contact information
Practice address
2750 OLD ALABAMA RD, SUITE 200, JOHNS CREEK, GA 30022-8593
(678) 893-5300
(678) 893-5312
Mailing address
2750 OLD ALABAMA RD, SUITE 200, JOHNS CREEK, GA 30022-8593
(678) 893-5300
(678) 893-5312
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC008494
GA
106H00000X
Marriage & Family Therapist
Primary
MFT001506
GA
Other
Enumeration date
09/07/2006
Last updated
09/24/2018
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