Individual
MOLLY MICHELLE TIEXIERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
514 W MAPLE ST STE 106, CUMMING, GA 30040-2420
(770) 740-5135
Mailing address
514 W MAPLE ST STE 106, CUMMING, GA 30040-2420
(770) 740-5135
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070532330
LICENSE
GA
Enumeration date
11/30/2022
Last updated
11/30/2022
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