Individual
MS. GINA VINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1810 PEACHTREE INDUSTRIAL BLVD, SUITE 231, DULUTH, GA 30097-8180
(770) 963-3349
Mailing address
665 ASHLEY LAINE WALK, LAWRENCEVILLE, GA 30043-4260
(770) 963-3349
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC004476
GA
Other
Enumeration date
04/23/2009
Last updated
04/23/2009
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