Individual
MR. LYLE KEITH COALWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
6488 SPRING ST, SUITE 102, DOUGLASVILLE, GA 30134-1895
(770) 949-1595
(770) 489-7521
Mailing address
6488 SPRING ST, SUITE 102, DOUGLASVILLE, GA 30134-1895
(770) 949-1595
(770) 489-7521
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC002580
GA
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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