Individual
ANDREA CORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5300 BRICKLEBERRY WAY STE 206, DOUGLASVILLE, GA 30134-4068
(678) 886-0999
Mailing address
5300 BRICKLEBERRY WAY STE 206, DOUGLASVILLE, GA 30134-4068
(678) 886-0999
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006703
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003239367A
—
GA
Enumeration date
12/10/2020
Last updated
12/10/2020
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