Provider Demographics
NPI:1093968349
Name:TEMIN, LAURA BETH (MA, LPC, LMFT, DCC,)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:TEMIN
Suffix:
Gender:F
Credentials:MA, LPC, LMFT, DCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 TOLLESON CT
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-3617
Mailing Address - Country:US
Mailing Address - Phone:770-998-3881
Mailing Address - Fax:678-878-2502
Practice Address - Street 1:1025 OLD ROSWELL RD STE 103
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1615
Practice Address - Country:US
Practice Address - Phone:770-998-3881
Practice Address - Fax:678-878-2502
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001147106H00000X
GALPC005619101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional