Kimberley Canupp Colluro, LPC

NPI #1689646192 in Braselton, Georgia

Provider Information

NPI Number: 1689646192
Entity Type: Individual
Name: Kimberley Canupp Colluro, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Feb 7, 2006
Last Updated: Mar 20, 2013

Practice Location

Address: 26 CHARLIE SMITH RD
City: Braselton
State: Georgia
ZIP Code: 30517-2500
Phone: (770) 654-6836

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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