Individual
MRS. AUDREY LOU ST. JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMP, CNMT, LMT
Contact information
Practice address
1204 HOSPITALITY AVE, SUITE K, KINGSLAND, GA 31548-6810
(912) 510-0264
Mailing address
112 CARNATION CT, KINGSLAND, GA 31548-5606
(912) 227-4474
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 44253
FL
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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