Individual
MRS. CHA'KE'SHA SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1050 SHILOH RD NW STE 316, KENNESAW, GA 30144-8100
(678) 213-2194
Mailing address
PO BOX 863, DOUGLASVILLE, GA 30133-0863
(404) 694-4668
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC004886
GA
101YM0800X
Mental Health Counselor
LPC004886
GA
101YP2500X
Professional Counselor
Primary
LPC004886
GA
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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