Individual
KRYSTAL LYLE LUMPKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9876 MAIN ST STE 100, WOODSTOCK, GA 30188-3990
(770) 516-1050
Mailing address
1414 WINDMOOR CT NW, KENNESAW, GA 30144-1269
(404) 809-7374
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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