Individual
FREDERICK D BROCKINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAPC
Contact information
Practice address
235 E PONCE DE LEON AVE STE 103, DECATUR, GA 30030-3412
(678) 753-5248
(404) 585-3054
Mailing address
235 E PONCE DE LEON AVE STE 103, DECATUR, GA 30030-3412
(678) 753-5248
(404) 585-3054
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC006305
GA
Other
Enumeration date
04/15/2018
Last updated
04/15/2018
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