Provider Demographics
NPI:1659047660
Name:GUMBS, ROSYLIA EUNIKA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROSYLIA
Middle Name:EUNIKA
Last Name:GUMBS
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 1:2369 CENTENARY WAY CT
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1329
Mailing Address - Country:US
Mailing Address - Phone:706-399-4329
Mailing Address - Fax:
Practice Address - Street 1:2369 CENTENARY WAY CT
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1329
Practice Address - Country:US
Practice Address - Phone:706-399-4329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012386101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional