Individual
JENNY K BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
270 CARPENTER DR STE 400, ATLANTA, GA 30328-4933
(678) 460-0345
Mailing address
729 WYNHOLLOW TRCE APT 3, NORCROSS, GA 30071-4015
(347) 575-0445
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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