Individual
LILY SCIVICQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 790-0800
Mailing address
1032 LENA ST NW, ATLANTA, GA 30314-2953
(404) 790-0800
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008657
GA
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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