Organization
MARIETTA COUNSELING PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER MINNICKS LCSW (OWNER)
(912) 690-4911
Entity
Organization
Contact information
Practice address
13 W PARK SQ NE STE D, MARIETTA, GA 30060-2294
(404) 494-0518
Mailing address
13 W PARK SQ NE STE D, MARIETTA, GA 30060-2294
(404) 494-0518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/03/2019
Last updated
08/02/2021
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