Individual
DEIDRA R BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3755 REDWINE RD APT 11210, ATLANTA, GA 30344-5975
(404) 729-0760
Mailing address
3755 REDWINE RD APT 11210, ATLANTA, GA 30344
(404) 729-0760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
008407
GA
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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