Individual
LATOYA NICHOLE POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
867 BUIE WAY, LAWRENCEVILLE, GA 30045-7191
(678) 598-1234
Mailing address
867 BUIE WAY, LAWRENCEVILLE, GA 30045-7191
(678) 598-1234
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006396
GA
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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