Provider Demographics
NPI:1760558563
Name:DRINKO, MARIE S (LIC PROF COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:S
Last Name:DRINKO
Suffix:
Gender:F
Credentials:LIC PROF COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 ROBIN CT
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7244
Mailing Address - Country:US
Mailing Address - Phone:770-975-3206
Mailing Address - Fax:770-975-3507
Practice Address - Street 1:3440 BLUE SPRINGS RD
Practice Address - Street 2:STE 503
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144
Practice Address - Country:US
Practice Address - Phone:404-513-5053
Practice Address - Fax:770-975-3507
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health