Individual
MRS. KIMBERLY BRYANT MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 N EXPRESSWAY STE B, GRIFFIN, GA 30223-1185
(678) 408-4622
Mailing address
1001 VILLA POINT PKWY, MCDONOUGH, GA 30253-9226
(404) 519-2639
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
LPC013676
GA
101YP2500X
Professional Counselor
—
GA
Other
Enumeration date
09/26/2019
Last updated
04/19/2023
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