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Individual

DESTINY BROOKE HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1200 ASHWOOD PKWY STE 400, ATLANTA, GA 30338-4749
(770) 336-7444
Mailing address
PO BOX 52261, ATLANTA, GA 30355-0261

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC006241
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1508399759
FACILITY
GA
Enumeration date
09/20/2019
Last updated
09/20/2019
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