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Individual

JASMINE FONTENOT-HARRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
6737 BILL CARRUTH PKWY APT 6133, HIRAM, GA 30141-3784
(678) 787-8971
Mailing address
6737 BILL CARRUTH PKWY APT 6133, HIRAM, GA 30141-3784

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MFT001658
GA
106H00000X
Marriage & Family Therapist
Primary
MFT001658
GA

Other

Enumeration date
12/05/2018
Last updated
12/05/2018
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