Kathleen Shack M.S., LMFT

NPI 1164567137 - Marriage & Family Therapist - 106H00000X

NPI Details
NPI 1164567137
Gender Female
Enumeration Date 02/20/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
290 CONSTITUTION BLVD
SUITE D
LAWRENCEVILLE GA, 30045-5638, US
Phone (678) 220-0090
Fax
Business Location
5825 MILLWICK DR
ALPHARETTA GA, 30005-6732, US
Phone (678) 770-2200
Fax
Toxanomy
Taxonomy Code 106H00000X
License State Georgia
License Number 0000928
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According to our database, Mrs. Kathleen Shack M.S., LMFT NPI is 1164567137, taxonomy code is 106H00000X and license number is 0000928, license state is located at Georgia. Kathleen Shack M.S., LMFT physically located at 290 Constitution Blvd, Lawrenceville GA, 30045-5638. NPI Number Kathleen Shack M.S., LMFT has the Individual type.

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1164567137 NPI number is provided on an as is basis without warranty of any kind. 1164567137 is maintained by the National Plan & Provider Enumeration System. The contents of Kathleen Shack M.S., LMFT are for informational purposes only.