Individual
MS. LA-KINYA WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1011 ELDON LN, FAIRBURN, GA 30213-5821
(678) 768-1779
Mailing address
1011 ELDON LN, FAIRBURN, GA 30213-5821
(678) 768-1779
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26-122849
SOCIAL SECURITY
GA
Enumeration date
01/16/2020
Last updated
01/16/2020
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