Organization
SOUTHERN PSYCHOLOGICAL AND BEHAVIORAL SERVICES, LLC
Active
Other names
SPBS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TWYLA LUCINDA MANCIL PH. D. (LICENSED PSYCHOLOGIST/OWNER)
(352) 727-8679
Entity
Organization
Contact information
Practice address
202 W GORDON ST, SUITE D, VALDOSTA, GA 31601-4569
(229) 474-9800
(229) 515-4443
Mailing address
202 W GORDON ST, SUITE D, VALDOSTA, GA 31601-4569
(229) 474-9800
(229) 515-4443
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003935
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00316809A
—
GA
Enumeration date
05/26/2016
Last updated
05/26/2016
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