Organization
AUTHENTIC LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA CLEGG MS, LPC, CEDS (OWNER & EXECUTIVE DIRECTOR)
(404) 295-1359
Entity
Organization
Contact information
Practice address
315 W PONCE DE LEON AVE, SUITE 835, DECATUR, GA 30030-2400
(404) 295-1359
Mailing address
315 W PONCE DE LEON AVE, SUITE 835, DECATUR, GA 30030-2400
(404) 295-1359
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004898
GA
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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