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Individual

MR. HERBERT S CHURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
209B SWANTON WAY STE 204, DECATUR, GA 30030-3271
(404) 354-4026
Mailing address
3137 MEDLEY CT NW, KENNESAW, GA 30152-6971
(770) 617-7421

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC010749
GA

Other

Enumeration date
01/25/2021
Last updated
01/25/2021
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