Individual
MRS. LYDIA MAE ROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
106 E CENTER ST, CARROLLTON, GA 30117-3303
(770) 639-3804
(770) 830-8322
Mailing address
7106 E ISLEWAY CT, VILLA RICA, GA 30180-3969
(770) 639-3804
(770) 830-8322
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001520
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321689374A
—
GA
Enumeration date
03/14/2007
Last updated
02/09/2010
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