Provider Demographics
NPI:1043037153
Name:NOGUERE, CHRISTINE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:NOGUERE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:MARBLE HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30148-0074
Mailing Address - Country:US
Mailing Address - Phone:770-355-3998
Mailing Address - Fax:
Practice Address - Street 1:977 ENOTA AVE NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1700
Practice Address - Country:US
Practice Address - Phone:470-290-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015126101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional