Individual
MR. JEAN B BEAUFILS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
500 LANIER AVE W STE 504, FAYETTEVILLE, GA 30214-7637
(678) 817-1120
Mailing address
2009 CHANNING DR, CONYERS, GA 30094-4164
(267) 254-5643
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC007339
GA
251S00000X
Community/Behavioral Health Agency
Primary
LPC007339
GA
Other
Enumeration date
08/12/2013
Last updated
10/26/2017
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