Individual
MELISSA SUZANNE REGISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
72 MEDDERS RD, HAZLEHURST, GA 31539-4216
(478) 733-3673
Mailing address
72 MEDDERS RD, HAZLEHURST, GA 31539-4216
(478) 733-3673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0161
GA
101YP2500X
Professional Counselor
Primary
0161012497
GA
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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