Jacqueline Alexandra Lilly, LPC

NPI #1205479490 in Woodstock, Georgia

Provider Information

NPI Number: 1205479490
Entity Type: Individual
Name: Jacqueline Alexandra Lilly, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: LPC
Enumeration Date: Oct 21, 2019
Last Updated: Oct 21, 2019

Practice Location

Address: 700 CHURCHILL CT STE 110
City: Woodstock
State: Georgia
ZIP Code: 30188-6880
Phone: (770) 284-9092

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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