Individual
JOSEPH MATT STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAPC
Contact information
Practice address
463B ERNEST BILES DR, JACKSON, GA 30233-2229
(770) 358-5252
Mailing address
1501A KALAMAZOO DR, GRIFFIN, GA 30224-3919
(770) 358-8257
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC002845
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000601609A
—
GA
Enumeration date
04/19/2012
Last updated
04/19/2012
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