Individual
DR. IAN JAMES MUDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
5320 CUMBERLAND WAY, STONE MOUNTAIN, GA 30087-4211
(862) 201-3495
Mailing address
5320 CUMBERLAND WAY, STONE MOUNTAIN, GA 30087-4211
(862) 201-3495
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC013731
GA
Other
Enumeration date
03/28/2020
Last updated
07/11/2024
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