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Individual

KENNETH CHRISTOPHER HAIDER-BARDILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1060 LENA ST NW, ATLANTA, GA 30314-2953
(678) 488-0766
Mailing address
1060 LENA ST NW, ATLANTA, GA 30314-2953
(678) 488-0766

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
APC003325
GA
101YP2500X
Professional Counselor
Primary
LPC008084
GA

Other

Enumeration date
04/03/2012
Last updated
03/07/2022
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