Individual
JENNIFER FIELD MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
200 MEDICAL LN, CANTON, GA 30114-2421
(770) 403-1906
(770) 720-3492
Mailing address
200 MEDICAL LN, CANTON, GA 30114-2421
(770) 403-1906
(770) 720-3492
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC003893
GA
Other
Enumeration date
11/28/2006
Last updated
06/20/2012
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