Individual
ESSENCE FIDDEMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1030 GRANT STREET SE, SUITE 2, ATLANTA, GA 30315
(518) 445-5369
Mailing address
8719 POST OAK DR, WINSTON, GA 30187-1714
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC007100
GA
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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