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Individual

MRS. BONNIE JEAN DEAROLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
211 PLEASANT HOME RD, SUITE B-2, AUGUSTA, GA 30907-0518
(706) 854-1600
(706) 854-0432
Mailing address
4113 NICOLES LN, GROVETOWN, GA 30813-4225
(706) 854-1600
(706) 854-0432

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC002382
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC002382
LPC STATE LICENSE NUMBER
GA
Enumeration date
01/19/2010
Last updated
01/19/2010
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