Individual
STACY JAYNES ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
6130 PRESTLEY MILL RD, SUITE A, DOUGLASVILLE, GA 30134-2288
(770) 949-9675
(770) 949-9676
Mailing address
6130 PRESTLEY MILL RD, SUITE A, DOUGLASVILLE, GA 30134-2288
(770) 949-9675
(770) 949-9676
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC004243
GA
Other
Enumeration date
03/31/2006
Last updated
07/08/2007
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