Individual
DEANA JO VIVIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 VIRGINIA AVE STE 212, ATLANTA, GA 30354-1387
(678) 994-5694
Mailing address
1003 VIRGINIA AVE STE 212, ATLANTA, GA 30354-1387
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009559
GA
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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