NPI 1164567137

Kathleen Shack, MSLMFT

Practitioner Marriage & Family Therapist Lawrenceville, GA

Practice location

Address: 290 Constitution Blvd Suite D, Lawrenceville, GA 30045-5638
Phone: (678) 220-0090
Mailing address: 5825 Millwick Dr, Alpharetta, GA 30005-6732

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X Licence 0000928 (GA)

Other Marriage & Family Therapist providers in Georgia →

Registry record

NPI: 1164567137
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Feb 2007
Record last updated: 8 Jul 2007

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.