Provider Demographics
NPI:1609150077
Name:HARPER, MARNIE LEE (LPC)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:LEE
Last Name:HARPER
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 1:1080 ROBINHOOD RD
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-1812
Mailing Address - Country:US
Mailing Address - Phone:706-654-6146
Mailing Address - Fax:
Practice Address - Street 1:1080 ROBINHOOD RD
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-1812
Practice Address - Country:US
Practice Address - Phone:706-654-6146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional