Individual
MRS. MARISSA MUNDY CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC, NCC
Contact information
Practice address
23 LENOX POINTE NE, ATLANTA, GA 30324-3172
(678) 977-9313
Mailing address
23 LENOX POINTE NE, ATLANTA, GA 30324-3172
(678) 977-9313
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
APC003577
GA
101YP2500X
Professional Counselor
Primary
LPC008452
GA
Other
Enumeration date
09/14/2012
Last updated
06/28/2016
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