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Individual

MRS. CHARKELA JENEA GASTON MOLDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.S., LPC, NCC

Contact information

Practice address
100 UNIVERSITY PKWY, MACON, GA 31206-5145
(478) 471-2985
(478) 471-5730
Mailing address
100 UNIVERSITY PKWY, MACON, GA 31206-5145
(478) 471-2985

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
APC005189
GA
101YP2500X
Professional Counselor
Primary
LPC009996
GA

Other

Enumeration date
11/15/2016
Last updated
01/25/2019
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