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Individual

MS. TAIVIA NICOSI THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1640 POWERS FERRY RD SE, MARIETTA, GA 30067-5491
(404) 435-2318
Mailing address
1822 PANOLA RD, LITHONIA, GA 30058-5518
(404) 435-2318

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
08/11/2020
Last updated
08/11/2020
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