Individual
MR. GABRIEL DAVID FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT, LPC
Contact information
Practice address
698 N MARIETTA PKWY NE, MARIETTA, GA 30060-1585
(770) 919-9088
Mailing address
698 N MARIETTA PKWY NE, MARIETTA, GA 30060-1585
(770) 919-9088
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC006828
GA
106H00000X
Marriage & Family Therapist
Primary
MFT001190
GA
Other
Enumeration date
09/12/2011
Last updated
07/29/2012
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