Individual
JAYNE LYNN VANDERGRINTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.,L.P.C.
Contact information
Practice address
2150 PEACHFORD RD STE B, ATLANTA, GA 30338-6539
(770) 457-7994
(770) 458-8656
Mailing address
2150 PEACHFORD RD. SUITE B, ATLANTA, GA 30338
(770) 457-7994
(770) 458-8656
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC005070
GA
163W00000X
Registered Nurse
RN053573
GA
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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