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Individual

JIMMY ENOBABOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
244 COMMERCE DR, DECATUR, GA 30030-1966
(817) 987-3385

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
Primary
009486
GA

Other

Enumeration date
08/22/2023
Last updated
01/15/2026
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