Individual
LATESHA EVETTE CLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1722 SEASONS PKWY, NORCROSS, GA 30093-3111
(912) 570-5963
Mailing address
1722 SEASONS PKWY, NORCROSS, GA 30093-3111
(912) 570-5963
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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