Provider Demographics
NPI:1760823710
Name:PULLEY, JOANNE M (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:M
Last Name:PULLEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MRS
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:MAZZUCHELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:4015 S COBB DR SE STE 250
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6316
Mailing Address - Country:US
Mailing Address - Phone:770-434-4568
Mailing Address - Fax:
Practice Address - Street 1:4015 S COBB DR SE STE 250
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6316
Practice Address - Country:US
Practice Address - Phone:770-434-4568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-07
Last Update Date:2013-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003452101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional