Individual
MOLLY BRACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12705 CENTURY DR, SUITE D, ALPHARETTA, GA 30009-8365
(678) 852-4224
Mailing address
252 S VILLAGE SQ, CANTON, GA 30115-1861
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC004680
GA
Other
Enumeration date
01/08/2016
Last updated
01/08/2016
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