Individual
JACQUELINE NYESHA ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
2935 ROSEBUD RD, UNIT 1708, LOGANVILLE, GA 30052-3069
(404) 573-2093
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC008787
GA
101YP2500X
Professional Counselor
Primary
LPC008787
GA
Other
Enumeration date
12/03/2016
Last updated
12/03/2016
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