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1205479490
JACQUELINE ALEXANDRA LILLY
WOODSTOCK, GA
NPI
1205479490
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Former Name
JACQUELINE ALEXANDRA RYANCZAK
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-10-21
Last Update Date
2019-10-21
Business Address
JACQUELINE ALEXANDRA LILLY LPC
700 CHURCHILL CT STE 110
WOODSTOCK, GA 30188-6880
Phone number: 770-284-9092
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Mailing Address
JACQUELINE ALEXANDRA LILLY LPC
1734 TAPPAHANNOCK TRL
MARIETTA, GA 30062-2087
Phone number:
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