Individual
MRS. STEPHANIE WALTHOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3400 CHAPEL HILL RD STE 317, DOUGLASVILLE, GA 30135
(704) 293-9875
Mailing address
5059 IRVINE DR, DOUGLASVILLE, GA 30135-2042
(704) 293-9875
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001585
GA
106H00000X
Marriage & Family Therapist
MT3245
FL
Other
Enumeration date
01/05/2017
Last updated
07/02/2018
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