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Individual

LISA GUEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
450 WINN WAY, DECATUR, GA 30030-1715
(404) 294-0499
Mailing address
2888 BRIDLE CREEK DR SW, CONYERS, GA 30094-5677
(866) 325-5434
(866) 325-5340

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009668
GA
104100000X
Social Worker
MSW006017
GA

Other

Enumeration date
09/10/2015
Last updated
10/02/2024
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