NPI 1043657075

Avenues of Change

Organisation Professional Counselor Marietta, GA

Practice location

Address: 1568 Cloverdale Dr SE, Marietta, GA 30067-7406
Phone: (770) 713-4574
Mailing address: 132 Gallery Court, Acworth, GA 30101

Authorised official

Name: Maryann Smolko-Self
Title: Owner/Lpc
Phone: (770) 713-4574

Registered specialties

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence LPC004657 (GA)

Other Counselor providers in Georgia →

Registry record

NPI: 1043657075
Entity type: Organization
NPI issued: 31 May 2013
Record last updated: 31 May 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.