Individual
MR. JAVIER ELIZALDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NCAC II
Contact information
Practice address
6020 DAWSON BLVD STE I, NORCROSS, GA 30093-1259
(770) 662-0249
(770) 449-5023
Mailing address
6020 DAWSON BLVD STE I, NORCROSS, GA 30093-1259
(770) 662-0249
(770) 449-5023
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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