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Individual

CASEY SHOPPY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
314 TRIBBLE GAP RD STE B, CUMMING, GA 30040-2475
(770) 615-6115
Mailing address
11046 ALPHARETTA HWY APT 3128, ROSWELL, GA 30076-5747
(678) 906-5239

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
009595
GA
101YM0800X
Mental Health Counselor
009595
GA
101YP2500X
Professional Counselor
Primary
009595
GA

Other

Enumeration date
07/09/2024
Last updated
07/09/2024
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