Individual
SUZANNE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
309 PIRKLE FERRY RD, A 400, CUMMING, GA 30040-2545
(770) 598-4034
(706) 865-0656
Mailing address
PO BOX 999, DAHLONEGA, GA 30533-0017
(770) 598-4034
(706) 865-0656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC003440
GA
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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