Individual
MICHELLE DENISE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MA, LGADC, CMAC
Contact information
Practice address
2005 TOWNE PARK DR, MCDONOUGH, GA 30252-6871
(443) 851-0179
Mailing address
2005 TOWNE PARK DR, MCDONOUGH, GA 30252-6871
(443) 851-0179
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0105
GA
Other
Enumeration date
05/16/2022
Last updated
05/16/2022
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