Individual
MRS. ALLISON ZITO BASHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPC
Contact information
Practice address
555 SUN VALLEY DR, SUITE P-4, ROSWELL, GA 30076-5612
(678) 381-1687
(678) 381-8020
Mailing address
555 SUN VALLEY DR, SUITE P-4, ROSWELL, GA 30076-5612
(678) 381-1687
(678) 381-8020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LPC006374
GA
101YM0800X
Mental Health Counselor
LPC006374
GA
101YP2500X
Professional Counselor
LPC006374
GA
Other
Enumeration date
04/24/2013
Last updated
06/22/2016
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