Provider Demographics
NPI:1598773665
Name:KRAKOW, DOROTHY (LPC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:KRAKOW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 TURKEY RUN RD
Mailing Address - Street 2:
Mailing Address - City:JULIETTE
Mailing Address - State:GA
Mailing Address - Zip Code:31046-4408
Mailing Address - Country:US
Mailing Address - Phone:478-955-0299
Mailing Address - Fax:478-741-9033
Practice Address - Street 1:280 TURKEY RUN RD
Practice Address - Street 2:
Practice Address - City:JULIETTE
Practice Address - State:GA
Practice Address - Zip Code:31046-4408
Practice Address - Country:US
Practice Address - Phone:478-955-0299
Practice Address - Fax:478-741-9033
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional