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Organization
BUMP CANCER, CORP
Active
Organization
BUMP CANCER, CORP
Active
Other names
Bump Cancer
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WYLLIE V MCGRUDER LPC, NCC, MS (OWNER/DIRECTOR)
(706) 358-7958
Entity
Organization
Contact information
Practice address
233 12TH ST, COLUMBUS, GA 31901-2462
(706) 358-7958
Mailing address
233 12TH ST, COLUMBUS, GA 31901-2462
(706) 358-7958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010144
GA
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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