Individual
JACOB GILBREATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
230 W COLLEGE ST STE D, GRIFFIN, GA 30224-4249
(678) 688-3133
Mailing address
115 SHELDON WAY, FAYETTEVILLE, GA 30215-7720
(706) 289-6685
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC014841
GA
Other
Enumeration date
07/11/2023
Last updated
07/26/2024
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