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Individual

MRS. MARIA MICAELA ISTRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
2900 CHAMBLEE TUCKER RD BLDG 12, ATLANTA, GA 30341-4100
(404) 480-0887
Mailing address
925 CANTERBURY RD NE APT 1020, ATLANTA, GA 30324-2898
(702) 885-6840

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC006936
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467745000
NPI
LA
Enumeration date
05/06/2016
Last updated
07/30/2019
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