Individual
KIMBERLI DAWN PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, LPC
Contact information
Practice address
44 COTTONWOOD ST., CLAYTON, GA 30525
(706) 782-0717
(706) 782-5266
Mailing address
PO BOX 1689, CLAYTON, GA 30525-0043
(706) 782-0717
(706) 782-5266
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC4008
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
514597267A
—
GA
Enumeration date
08/05/2008
Last updated
08/05/2008
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