Individual
MRS. GRATIANA WILSON TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
110 EAGLE SPRING DR, STOCKBRIDGE, GA 30281-6488
(678) 712-1948
Mailing address
1990 EAGLE RIDGE DR SW, CONYERS, GA 30094-3377
(678) 712-1948
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006127
GA
Other
Enumeration date
11/07/2006
Last updated
08/17/2011
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