Organization
DVINE SYSTEMS GA LLC
Active
Other names
Dvine Systems GA LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDORA DVINE LPC (C.E.O.)
(678) 212-5146
Entity
Organization
Contact information
Practice address
255 RACETRACK RD, 26, MCDONOUGH, GA 30252-6834
(678) 212-5146
(678) 831-3554
Mailing address
255 RACETRACK RD, #26, MCDONOUGH, GA 30252-6834
(678) 212-5146
(678) 831-3554
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006210
GA
Other
Enumeration date
06/08/2010
Last updated
11/11/2014
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