Individual
LATISE EGESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4290 MEMORIAL DR, DECATUR, GA 30032-1225
(404) 294-0774
(404) 294-0775
Mailing address
3578 S FULTON AVE, HAPEVILLE, GA 30354-1756
(404) 669-3462
(404) 669-3957
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003589
GA
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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