Individual
BRANDON SUPAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2760 PEACHTREE INDUSTRIAL BLVD STE C, DULUTH, GA 30097-2201
(470) 502-5637
Mailing address
2753 HOLLY RIDGE CIR, MARIETTA, GA 30062-4632
(845) 987-4458
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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