Organization
ILLUMINATION COUNSELING AND COACHING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATASHA MATTHEWS (OWNER)
(678) 585-1966
Entity
Organization
Contact information
Practice address
1840 OLD NORCROSS RD, 300, LAWRENCEVILLE, GA 30044-8803
(678) 585-1966
Mailing address
1840 OLD NORCROSS RD, 300, LAWRENCEVILLE, GA 30044-8803
(678) 585-1966
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006599
GA
Other
Enumeration date
10/07/2015
Last updated
06/06/2020
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