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STARLAN JAMES CHILDERS

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1306408984

Individual Registrant:
 STARLAN JAMES CHILDERS 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2007 OLD LAFAYETTE RD  FORT OGLETHORPE, GA 30742-3510 US
Tel: 706-861-9390  Fax: --

Contact information for business:
2007 OLD LAFAYETTE RD  FORT OGLETHORPE, GA 30742-3510 US
Tel: 706-861-9390  Fax: --

Registration Information:
NPI: 1306408984
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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