Most Relevant Information
Provider Data
| NPI Number: | 1003221144 |
| Provider Name: | DUSTIN LEIGH SHANDY LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | LPC014155 |
Most Important Dates
| Enumeration Date: | 06/27/2014 |
| Last Updated: | 01/16/2024 |
Provider Practice Location
3611 BRASELTON HWY STE 201
DACULA
GA
300194673
Practice Location Phone/Fax
| Phone: | 6782801390 |
| Fax: |
Provider Mailing Location
3611 BRASELTON HWY STE 201
DACULA
GA
300194673
Provider Mailing Phone/Fax
| Phone: | 6782801390 |
| Fax: |