Individual
SUSAN BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
755 MOUNT VERNON HWY NE, STE 330, ATLANTA, GA 30328-4274
(404) 256-2277
(404) 250-0025
Mailing address
284 S MAIN ST, SUITE 800, ALPHARETTA, GA 30009-7904
(678) 575-4315
(404) 250-0025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC007811
GA
Other
Enumeration date
11/05/2014
Last updated
07/06/2016
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