Provider Demographics
NPI:1750895785
Name:MINDAY, EMILY GRACE (MA, APC, CCTP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:GRACE
Last Name:MINDAY
Suffix:
Gender:F
Credentials:MA, APC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 ARBOR LANDING DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-2250
Mailing Address - Country:US
Mailing Address - Phone:678-267-6170
Mailing Address - Fax:
Practice Address - Street 1:4343 SHALLOWFORD ROAD BUILDING C
Practice Address - Street 2:SUITE 1 LOWER LEVEL
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:678-267-6170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC004695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional