Individual
MRS. ANNALISA DERENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC, NCC
Contact information
Practice address
11285 ELKINS RD, D-4, ROSWELL, GA 30076-1259
(678) 431-3901
(770) 521-0512
Mailing address
530 JON SCOTT DR, ALPHARETTA, GA 30004-2125
(678) 431-3901
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004373
GA
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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