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1902361553
JON PATRICK COSTALES
CANTON, GA
NPI
1902361553
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA LPC009867)
Enumeration Date
2019-02-07
Last Update Date
2019-02-07
Business Address
JON PATRICK COSTALES LPC
310 PAPER TRAIL WAY STE 106
CANTON, GA 30115-5204
Phone number: 678-880-4645
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Mailing Address
JON PATRICK COSTALES LPC
7339 REINHARDT COLLEGE PKWY
WALESKA, GA 30183-2901
Phone number: 404-446-7678
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