Individual
TERRY R. CHASTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
5294 LAWRENCEVILLE HWY, B-5, LILBURN, GA 30047
(770) 931-3588
(770) 717-7328
Mailing address
5203 CHARLEMAGNE WAY, LILBURN, GA 30047
(770) 381-1402
(770) 717-7328
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LPC004464
GA
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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