| Theresa Masek,lpc | |
|
415 Dixie St Carrollton GA 30117-3921 | |
| (678) 378-3226 | |
| (770) 836-1827 |
| Full Name | Theresa Masek,lpc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 415 Dixie St, Carrollton, Georgia |
| Authorized Official Name and Position | Theresa Masek (LPC) |
| Authorized Official Contact | 6783783226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa Masek,lpc 1220 Davis Rd Carrollton GA 30116-8201 Ph: () - | Theresa Masek,lpc 415 Dixie St Carrollton GA 30117-3921 Ph: (678) 378-3226 |
| NPI Number | 1972791853 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 10/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972791853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC002436 (Georgia) | Primary |
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