Individual
KATHERINE STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3869 EVANS RD, ATLANTA, GA 30340-4629
(404) 569-3541
Mailing address
3869 EVANS RD, ATLANTA, GA 30340-4629
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC007666
GA
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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