Individual
LOREN RAE EASTERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 PIERCE AVE, LIGHTHOUSE FOR FAMILIES, MACON, GA 31204-2891
(478) 464-3025
Mailing address
116 PIERCE AVE, LIGHTHOUSE FOR FAMILIES, MACON, GA 31204-2891
(478) 464-3025
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC004699
GA
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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