Individual
MARY KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1944 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 289-6981
Mailing address
1944 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 289-6981
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC008089
GA
101YM0800X
Mental Health Counselor
LPC008089
GA
101YP1600X
Pastoral Counselor
LPC008089
GA
101YP2500X
Professional Counselor
LPC008089
GA
106H00000X
Marriage & Family Therapist
LPC008089
GA
Other
Enumeration date
02/21/2015
Last updated
02/21/2015
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