Individual
HIRA ASIF MOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
PO BOX 1034, MCDONOUGH, GA 30253-1034
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC008750
GA
106H00000X
Marriage & Family Therapist
132341
CA
Other
Enumeration date
04/30/2018
Last updated
11/22/2022
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