Individual
DANIELLE LIDKE-PROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
513 GLOUCESTER ST, BRUNSWICK, GA 31520-7014
(912) 289-2497
Mailing address
1117 KINGS CROSS, BRUNSWICK, GA 31525-6822
(303) 515-0125
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC012120
GA
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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