Individual
MISS LAXANDERIA DAWN ROVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1919 JOHN WESLEY AVE, COLLEGE PARK, GA 30337-3605
(404) 762-9190
(404) 762-9101
Mailing address
548 WOODLAND PARK TER, LAWRENCEVILLE, GA 30043-1420
(678) 336-9790
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAPC1057
GA
101YP2500X
Professional Counselor
Primary
LPC005258
GA
Other
Enumeration date
03/20/2008
Last updated
02/26/2013
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