Individual
LACONYA MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
292 W 4TH ST, WAYNESBORO, GA 30830-1559
(706) 437-6863
(706) 437-6860
Mailing address
223 N ANDERSON DR, P O BOX 1259, SWAINSBORO, GA 30401-4440
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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