Individual
DANA CAROL FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMFT
Contact information
Practice address
2024 POWERS FERRY RD SE, SUITE 120, ATLANTA, GA 30339-5011
(678) 381-3493
Mailing address
2024 POWERS FERRY RD SE, SUITE 120, ATLANTA, GA 30339-5011
(678) 381-3493
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC006591
GA
106H00000X
Marriage & Family Therapist
Primary
MFT001236
GA
Other
Enumeration date
12/12/2011
Last updated
02/14/2015
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