Individual
MRS. PORTIA R. DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
408 HUDSON LN, ALBANY, GA 31705-4018
(229) 869-5426
Mailing address
408 HUDSON LN, ALBANY, GA 31705-4018
(229) 869-5426
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AB12-000748
GA
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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