| Avenues Of Change | |
|
1568 Cloverdale Dr Se Marietta GA 30067-7406 | |
| (770) 713-4574 | |
| Not Available |
| Full Name | Avenues Of Change |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1568 Cloverdale Dr Se, Marietta, Georgia |
| Authorized Official Name and Position | Maryann Smolko-self (OWNER/LPC) |
| Authorized Official Contact | 7707134574 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avenues Of Change 132 Gallery Court Acworth GA 30101 Ph: (770) 713-4574 | Avenues Of Change 1568 Cloverdale Dr Se Marietta GA 30067-7406 Ph: (770) 713-4574 |
| NPI Number | 1043657075 |
|---|---|
| Provider Enumeration Date | 05/31/2013 |
| Last Update Date | 05/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043657075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC004657 (Georgia) | Primary |
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