Individual
MS. MATTIE GATES BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
37 SHARP ST, FORSYTH, GA 31029-1721
(478) 361-9774
Mailing address
37 SHARP ST, FORSYTH, GA 31029-1721
(478) 361-9774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000773
GA
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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