Provider Demographics
NPI:1093259608
Name:DRAPER, MEREDITH NICOLE (LAPC)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:NICOLE
Last Name:DRAPER
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WESTPARK DR
Mailing Address - Street 2:SUITE 325
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3534
Mailing Address - Country:US
Mailing Address - Phone:770-631-1553
Mailing Address - Fax:
Practice Address - Street 1:200 WESTPARK DR
Practice Address - Street 2:SUITE 325
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3534
Practice Address - Country:US
Practice Address - Phone:770-631-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC005074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAAPC005074OtherLAPC