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Individual

MRS. AVIS CLEMONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5300 MEMORIAL DR, SUITE 224A, STONE MOUNTAIN, GA 30083-3148
(678) 497-5975
(770) 908-2462
Mailing address
5720 WYNDEMERE LN, STONE MOUNTAIN, GA 30087-2525
(678) 497-5975
(770) 908-2462

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
02/05/2013
Last updated
02/05/2013
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