Individual
ELIZABETH EARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,LPC; MA,CCC-SLP
Contact information
Practice address
245 W WIEUCA RD NE STE 150, ATLANTA, GA 30342-3369
(404) 631-7934
Mailing address
PO BOX 219, MINERAL BLUFF, GA 30559-0219
(404) 386-4477
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010203
GA
101YP2500X
Professional Counselor
APC004814
GA
235Z00000X
Speech-Language Pathologist
SLP006268
GA
Other
Enumeration date
08/21/2015
Last updated
07/28/2022
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