Individual
MRS. CHARY ROBERTA CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
110 EVANS MILL DR STE 305, DALLAS, GA 30157-1623
(770) 445-6358
(770) 445-7262
Mailing address
3137 MEDLEY CT NW, KENNESAW, GA 30152-6971
(770) 218-3719
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004233
GA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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