Individual
JESSICA RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LPC
Contact information
Practice address
200 BEACON CV, CANTON, GA 30114-5892
(770) 595-9478
Mailing address
200 BEACON CV, CANTON, GA 30114-5892
(770) 595-9478
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
APC005008
GA
106H00000X
Marriage & Family Therapist
Primary
MFT001696
GA
Other
Enumeration date
09/29/2015
Last updated
12/22/2021
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