Organization
KATHY WAGNER COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN A WAGNER LPC (OWNER)
(678) 871-5927
Entity
Organization
Contact information
Practice address
262 S PEACHTREE PKWY, STE 4, PEACHTREE CITY, GA 30269-1751
(678) 871-5927
(770) 995-1959
Mailing address
175 MANOR DR, FAYETTEVILLE, GA 30215-2959
(678) 871-5927
(770) 995-1959
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006769
GA
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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