Individual
MRS. KATRINA TODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LAMFT,BCBA,MT-BC
Contact information
Practice address
3760 LAVISTA RD, SUITE 102, TUCKER, GA 30084-5615
(678) 626-0557
Mailing address
PO BOX 170062, ATLANTA, GA 30317-0062
(678) 626-0557
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10491
CA
106H00000X
Marriage & Family Therapist
AMFT000418
GA
225A00000X
Music Therapist
MUT000049
GA
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/26/2010
Last updated
07/18/2016
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