Individual
KRISTEN GAYLOR BROYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
105 REDMOND RD NW, ROME, GA 30165-1535
(706) 767-1421
Mailing address
601 SOUTH AVE SW, ROME, GA 30165-4217
(706) 767-1421
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC009961
GA
101YM0800X
Mental Health Counselor
Primary
LPC009961
GA
Other
Enumeration date
03/07/2019
Last updated
10/30/2022
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