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Richard Charles Lie-Nielsen, L.P.C.

Counselor, Professional in Smyrna, GA. Individual provider (NPI-1).

NPI number1124470729
StatusActive
Last updated in NPPESJul 7, 2016

Details

NPI
1124470729
Entity type
Individual (NPI-1)
Name
Mr. Richard Charles Lie-Nielsen
Credential
L.P.C.
Sex
Male
Sole proprietor
No
Enumeration date
Jul 7, 2016
Last updated
Jul 7, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional004695GAYes

Practice location

4015 S Cobb Dr Se
Suite 260
Smyrna, GA 30080-6303

Phone 678-760-2704 · Fax 770-432-8311

Mailing address

4015 S Cobb Dr Se
Suite 260
Smyrna, GA 30080-6303

Phone 678-760-2704 · Fax 770-432-8311

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