Provider Demographics
NPI:1619958865
Name:PARRIS, GINA W (EDS MSW LMFT)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:W
Last Name:PARRIS
Suffix:
Gender:F
Credentials:EDS MSW LMFT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3383 WOLF DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-1439
Mailing Address - Country:US
Mailing Address - Phone:770-841-2926
Mailing Address - Fax:678-985-5393
Practice Address - Street 1:3383 WOLF DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-1439
Practice Address - Country:US
Practice Address - Phone:770-841-2926
Practice Address - Fax:770-874-9083
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist