Individual
MR. MARCUS E. WINDHOM SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 SESSIONS DR, MACON, GA 31201-2317
(404) 625-5907
Mailing address
478 MONROE HL APT 310, MACON, GA 31204-6552
(404) 625-5907
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
IL
171M00000X
Case Manager/Care Coordinator
—
GA
171M00000X
Case Manager/Care Coordinator
Primary
—
IL
172V00000X
Community Health Worker
—
IL
252Y00000X
Early Intervention Provider Agency
—
IL
Other
Enumeration date
06/29/2020
Last updated
03/06/2023
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