Individual
SOUTHERNBELLE ENTERTAINMENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6483 SINCLAIR PL, MORROW, GA 30260-2727
(678) 249-5718
Mailing address
6483 SINCLAIR PL, MORROW, GA 30260-2727
Taxonomy
Speciality
Code
Description
License number
State
102X00000X
Poetry Therapist
—
—
106H00000X
Marriage & Family Therapist
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/26/2017
Last updated
06/26/2017
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