Individual
LATISHA WOODS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 PARKER RD SE, BLDG C, SUITE 210, CONYERS, GA 30094-6654
(678) 487-3781
Mailing address
1775 PARKER RD SE, BLDG C, SUITE 210, CONYERS, GA 30094-6654
(678) 487-3781
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC009456
GA
101YM0800X
Mental Health Counselor
Primary
LPC009456
GA
101YP2500X
Professional Counselor
LPC009456
GA
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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