Individual
CONSTANCE HARALSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1076 CREEKHEAD DR, VILLA RICA, GA 30180-3420
(404) 642-2616
Mailing address
1076 CREEKHEAD DR, VILLA RICA, GA 30180-3420
(404) 642-2616
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008085
GA
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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