Individual
STACEY DOUGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
696 MOUNTAIN DR NE, ATLANTA, GA 30342-3904
(404) 276-6965
Mailing address
696 MOUNTAIN DR NE, ATLANTA, GA 30342-3904
(404) 276-6965
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC011626
GA
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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