Individual
JOANNE MENSALVAS REQUIJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
233 12TH STREET SUITE 334, THE PSYCHOLOGY CLINIC, COLUMBUS, GA 31901-5333
(706) 225-0322
(706) 225-0321
Mailing address
233 12TH STREET SUITE 334, THE PSYCHOLOGY CLINICA, COLUMBUS, GA 31901-5333
(706) 225-0322
(706) 225-0321
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3551
AL
101Y00000X
Counselor
Primary
LPC009386
GA
Other
Enumeration date
07/09/2014
Last updated
01/23/2017
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