Individual
LESLIE H PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC
Contact information
Practice address
25B E MAIN ST, MANCHESTER, GA 31816-2114
(706) 366-2293
Mailing address
10105 WHITE HOUSE PKWY, WOODBURY, GA 30293-3101
(706) 366-2293
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC003725
GA
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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