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JOEANN JEARLENE SMITH

Adult Mental Health >> Clinic/Center >> Ambulatory Health Care Facilities

Registrant NPI Number: 1215416532

Individual Registrant:
 JOEANN JEARLENE SMITH 
Gender: F
Sole Proprietor

Location and contact information for practice:
9546 ENGLISH IVY CT  FORTSON, GA 31808-6962 US
Tel: 321-914-9747  Fax: --

Contact information for business:
9546 ENGLISH IVY CT  FORTSON, GA 31808-6962 US
Tel: 321-914-9747  Fax: --

Registration Information:
NPI: 1215416532
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QM0850XAmbulatory Health Care Facilities
Clinic/Center
Adult Mental Health

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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