Individual
DAKOTA JACK FIDRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3300 BUCKEYE RD STE 349, ATLANTA, GA 30341-4238
(678) 400-4441
Mailing address
3300 BUCKEYE RD STE 349, ATLANTA, GA 30341-4238
(678) 400-4441
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC015411
GA
Other
Enumeration date
02/05/2020
Last updated
02/14/2025
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