Individual
MS. KATHLEEN E BAZILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LPC
Contact information
Practice address
1900 THE EXCHANGE SE STE 100, ATLANTA, GA 30339-2022
(470) 231-6178
Mailing address
PO BOX 191321, ATLANTA, GA 31119-1321
(407) 529-8289
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC008451
GA
101YP2500X
Professional Counselor
LPC008451
GA
Other
Enumeration date
04/26/2009
Last updated
03/21/2024
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