Individual
KIMBERLEY CANUPP COLLURO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
26 CHARLIE SMITH RD, BRASELTON, GA 30517-2500
(770) 654-6836
Mailing address
5415 GOLF VIEW DR, BRASELTON, GA 30517-4043
(770) 654-6836
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004144
GA
Other
Enumeration date
02/07/2006
Last updated
03/20/2013
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