Organization
YOURTHERAPISTOFFICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEMAL DOUTE LMFT (MEMBER/CLINICIAN)
(678) 489-7384
Entity
Organization
Contact information
Practice address
90 COMMERCE DR, STE B, FAYETTEVILLE, GA 30214-7519
(678) 489-7384
(866) 311-8215
Mailing address
PO BOX 312, FAYETTEVILLE, GA 30214-0312
(678) 489-7384
(866) 311-8215
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
01277
GA
101YM0800X
Mental Health Counselor
001277
GA
106H00000X
Marriage & Family Therapist
Primary
001277
GA
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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