Individual
KEITH LONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5526 OLD NATIONAL HWY, ATLANTA, GA 30349-3212
(404) 543-4497
Mailing address
1616 VILLAGE PLACE CIR NE, CONYERS, GA 30012-7108
(404) 543-4497
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC003645
GA
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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