Individual
DIANA KEYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 EVANS MILL DR, DALLAS, GA 30157-1622
(678) 395-1933
Mailing address
975 PRICKETT LN, DOUGLASVILLE, GA 30134-4682
(678) 395-1933
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11111111
—
GA
Enumeration date
09/04/2014
Last updated
09/04/2014
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