Individual
MS. LINDA HEAVISIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC, NCC
Contact information
Practice address
1640 POWERS FERRY RD SE STE 300, MARIETTA, GA 30067-5491
(404) 423-8417
Mailing address
1640 POWERS FERRY RD SE STE 300, MARIETTA, GA 30067-5491
(404) 423-8417
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC007550
GA
Other
Enumeration date
05/05/2011
Last updated
03/14/2016
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