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JIMMIE DENSON
>> Community/Behavioral Health >> AgenciesRegistrant NPI Number: 1801433974
Individual Registrant: JIMMIE DENSON
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
894 KEMP RD LA FAYETTE, GA 30728-5016 US
Tel: 423-991-0034 Fax: --
Tel: 423-991-0034 Fax: --
Contact information for business:
501 MIZE ST LA FAYETTE, GA 30728-3346 US
Tel: 423-991-0034 Fax: --
Tel: 423-991-0034 Fax: --
Registration Information:
NPI: 1801433974
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 251S00000X | Agencies Community/Behavioral Health | GA |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
