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1063783462
TINA MARIE WALLIS
DAWSONVILLE, GA
NPI
1063783462
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA 006897)
Enumeration Date
2012-01-18
Last Update Date
2015-12-17
Business Address
-- TINA MARIE WALLIS LPC, CPCS
12 WATERFRONT PARK CT
DAWSONVILLE, GA 30534-5772
Phone number: 706-490-9204
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Mailing Address
-- TINA MARIE WALLIS LPC, CPCS
12 WATERFRONT PARK CT
DAWSONVILLE, GA 30534-5772
Phone number: 706-490-9204
Copy
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