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Individual

GEORGIANA BAGLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2245 GODBY RD STE 206, ATLANTA, GA 30349-5061
(404) 968-4662
(404) 968-4582
Mailing address
2245 GODBY RD STE 206, ATLANTA, GA 30349-5061
(404) 968-4662
(404) 968-4582

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LA001132
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
503205308A
GA
Enumeration date
01/14/2009
Last updated
01/14/2009
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