Individual
JILLIAN CANADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
(404) 486-9034
Mailing address
3423 VININGS NORTH TRL SE, SMYRNA, GA 30080-4581
(404) 536-6712
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC015257
GA
Other
Enumeration date
10/25/2022
Last updated
01/21/2025
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