Individual
LATOYA J PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC II, ICADC, MATS
Contact information
Practice address
1114 GA HIGHWAY 96 STE C1, KATHLEEN, GA 31047-4102
(478) 397-5988
Mailing address
1114 GA HIGHWAY 96 STE C1, KATHLEEN, GA 31047-4102
(478) 397-5988
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1283
GA
Other
Enumeration date
05/21/2019
Last updated
06/11/2019
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