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Individual

MRS. DONNA KAY THOMPSON-LISIECKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
710 BOWERY LN, BLDG. G BOX 41, FOLKSTON, GA 31537-5967
(912) 496-2616
(912) 496-2671
Mailing address
710 BOWERY LN, BLDG. G BOX 41, FOLKSTON, GA 31537-5967
(912) 617-0008
(912) 496-2671

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC004677
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20-8008619
FEDERAL EMPLOYER ID #
GA
Enumeration date
05/11/2007
Last updated
12/10/2014
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