Individual
MRS. JADESHALA HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
511 CANCUN CT, STATESBORO, GA 30458-6117
(912) 536-8028
Mailing address
511 CANCUN CT, STATESBORO, GA 30458-6117
(912) 536-8028
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
013892
GA
Other
Enumeration date
05/31/2023
Last updated
07/11/2023
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