Organization
BARCLAY LIGHT AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN BARCLAY LPC (OWNER)
(470) 355-8883
Entity
Organization
Contact information
Practice address
3645 MARKETPLACE BLVD STE 130, EAST POINT, GA 30344-5748
(470) 355-8883
(470) 355-8887
Mailing address
3645 MARKETPLACE BLVD STE 130, EAST POINT, GA 30344-5748
(470) 355-8883
(470) 355-8887
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9684
LICENSE
GA
Enumeration date
06/03/2019
Last updated
06/03/2019
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