Individual
NAN W DECOLAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
188 PLANTATION RD, N HIGH SHOALS, GA 30621-1511
(706) 202-6549
Mailing address
PO BOX 143, HIGH SHOALS, GA 30645-0143
(706) 202-6549
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
02/27/2021
Last updated
02/27/2021
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