Individual
ALISSA DEAN BOTTOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4145 COLUMBIA RD, AUGUSTA, GA 30907-5400
(706) 869-7373
Mailing address
4145 COLUMBIA RD, AUGUSTA, GA 30907-5400
(706) 869-7373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A14397
NC
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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