Individual
MICHELLE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1708 CHARLTON ST, VALDOSTA, GA 31602-3101
(229) 242-6292
Mailing address
1708 CHARLTON ST, VALDOSTA, GA 31602-3101
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
GA
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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