Individual
DISHECA RENEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
507 SHARPSTONE BND, STOCKBRIDGE, GA 30281-9434
(404) 484-5769
Mailing address
507 SHARPSTONE BND, STOCKBRIDGE, GA 30281-9434
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006491
GA
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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