Provider Demographics
NPI:1780777052
Name:DANIEL, MARILYN SUE (LPC)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:SUE
Last Name:DANIEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4501 CIRCLE 75 PKWY SE
Mailing Address - Street 2:SUITE 5220E
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3025
Mailing Address - Country:US
Mailing Address - Phone:770-845-3026
Mailing Address - Fax:770-579-1955
Practice Address - Street 1:4501 CIRCLE 75 PKWY SE
Practice Address - Street 2:SUITE 5220E
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3025
Practice Address - Country:US
Practice Address - Phone:770-845-3026
Practice Address - Fax:770-579-1955
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA1962101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional