Organization
THERESA MASEK,LPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA MASEK (LPC)
(678) 378-3226
Entity
Organization
Contact information
Practice address
415 DIXIE ST, CARROLLTON, GA 30117-3921
(678) 378-3226
(770) 836-1827
Mailing address
1220 DAVIS RD, CARROLLTON, GA 30116-8201
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC002436
GA
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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