Provider First Line Business Practice Location Address:
130 VANN ST NE STE 220
Provider Second Line Business Practice Location Address:
COUNSELING INNOVATIONS, LLC
Provider Business Practice Location Address City Name:
MARIETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30060-7230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-919-1077
Provider Business Practice Location Address Fax Number:
678-317-3991
Provider Enumeration Date:
07/25/2009