Individual
CHARLOTTE SPEED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
501 MIZE ST, LA FAYETTE, GA 30728-3346
(706) 538-5580
(706) 638-5445
Mailing address
501 MIZE ST, LA FAYETTE, GA 30728-3346
(706) 538-5580
(706) 638-5445
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
674
GA
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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