Individual
JEAN MARIE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
340 BRAMFORD WAY NW, KENNESAW, GA 30144-1337
(216) 402-0954
Mailing address
340 BRAMFORD WAY NW, KENNESAW, GA 30144-1337
(216) 402-0954
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
267
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC11-1903
GA
101YM0800X
Mental Health Counselor
LPC 0012407
OH
101YP2500X
Professional Counselor
Primary
LPC 005232
GA
104100000X
Social Worker
S 0012407
OH
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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