Organization
CHEROKEE CENTER FOR CHANGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ITA GILBERT DORE LPC (CLINICAL DIRECTOR)
(770) 928-7300
Entity
Organization
Contact information
Practice address
409 OLD BORING LN, WOODSTOCK, GA 30189-2495
(770) 928-7300
(770) 928-7558
Mailing address
409 OLD BORING LN, WOODSTOCK, GA 30189-2495
(770) 928-7300
(770) 928-7558
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2347
GA
Other
Enumeration date
11/10/2009
Last updated
11/10/2009
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