Individual
MRS. LISA KIRKPATRICK KETTERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
6548 HIGHWAY 92 STE 100, ACWORTH, GA 30102-2572
(678) 770-1280
Mailing address
19 BILLIES CV SE, ACWORTH, GA 30102-6894
(678) 770-1280
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC007035
GA
Other
Enumeration date
09/13/2018
Last updated
11/23/2019
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