Individual
MS. GENNIFER LEIGH VAN PELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
116 PIERCE AVE, MACON, GA 31204-2891
(478) 464-3001
Mailing address
116 PIERCE AVE, MACON, GA 31204-2891
(478) 464-3001
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC011903
GA
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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