Individual
MARINA ROSE PATE
Active
Individual
MARINA ROSE PATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC016718
GA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26-4503737
—
GA
Enumeration date
12/19/2022
Last updated
04/22/2026
Update your record
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