Individual
BRITTANY KETCHUP HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 VETERANS MEMORIAL HWY SE STE 660, MABLETON, GA 30126-7711
(678) 696-1824
Mailing address
1025 VETERANS MEMORIAL HWY SE STE 660, MABLETON, GA 30126-7711
(678) 696-1824
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
APC006917
GA
101YP2500X
Professional Counselor
Primary
LPC012859
GA
171W00000X
Contractor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6758
—
CA
05
—
7068
—
CA
05
—
7420
—
CA
Enumeration date
09/06/2017
Last updated
08/24/2022
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