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Individual

MRS. CHERYL GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
445 WINN WAY, DECATUR, GA 30030-1707
(404) 294-3836
Mailing address
858 COMMONWEALTH AVE SE, ATLANTA, GA 30312-3662
(404) 583-1532

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC00665
GA
101YP2500X
Professional Counselor
Primary
LPC006665
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003135787A
GA
Enumeration date
06/01/2012
Last updated
02/15/2021
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