Individual provider · Type 1 NPI

Andrew Provence, LPC

Professional Counselor · Griffin, GA

NPI number 1114079159 Active

Practice location

2000 W Mcintosh Rd
Griffin, GA 30223-6265

Call (678) 688-3133 Map

Fax (678) 688-3134

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLPC003592 (GA)

Professional Counselor: Definition to come...

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About NPI 1114079159

Andrew Provence, LPC's National Provider Identifier is 1114079159, issued on Jan 18, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Griffin, GA. The record was last updated on Jul 8, 2007.