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Individual

DEBRA M. TAIT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
801 THRIFT RD, WOODBINE, GA 31569-2436
(352) 339-2013
Mailing address
801 THRIFT RD, WOODBINE, GA 31569-2436
(352) 339-2013

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
008512
GA
101YP2500X
Professional Counselor
LPC008512
GA
101YP2500X
Professional Counselor

Other

Enumeration date
05/15/2013
Last updated
03/22/2019
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