Individual
MRS. MISTY LANE MCINTYRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
605 NEWNAN ST, CARROLLTON, GA 30117-3428
(770) 214-9811
Mailing address
605 NEWNAN ST, CARROLLTON, GA 30117-3428
(770) 214-9811
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001337
GA
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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