Individual
LYN C SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5628 TISBURY CT, HOSCHTON, GA 30548-5536
(770) 965-7570
Mailing address
5628 TISBURY CT, HOSCHTON, GA 30548-5536
(770) 965-7570
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC001359
GA
Other
Enumeration date
04/16/2021
Last updated
11/24/2021
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