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Individual

JOEANN JEARLENE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9546 ENGLISH IVY CT, FORTSON, GA 31808-6962
(321) 914-9747
Mailing address
9546 ENGLISH IVY CT, FORTSON, GA 31808-6962
(321) 914-9747

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Enumeration date
08/08/2018
Last updated
08/08/2018
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