Provider Demographics
NPI:1780728386
Name:ROLAND, ANN DAVIS (LMFT)
Entity type:Individual
Prefix:PROF
First Name:ANN
Middle Name:DAVIS
Last Name:ROLAND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 515
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30061-0515
Mailing Address - Country:US
Mailing Address - Phone:770-420-9448
Mailing Address - Fax:770-420-9441
Practice Address - Street 1:21 TRAMMELL STREET, SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3249
Practice Address - Country:US
Practice Address - Phone:770-420-9448
Practice Address - Fax:770-420-9441
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA897106H00000X
GA(GA) MFT 000897106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist