Individual
KYLIE JUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
812 HAMMOND DR, NORTH AUGUSTA, SC 29841-3228
(706) 750-4275
Mailing address
PO BOX 9443, AUGUSTA, GA 30916-9443
(706) 750-4375
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8040
GA
Other
Enumeration date
05/02/2022
Last updated
05/02/2022
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