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Individual

AKIA SHAUAAN MADDOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2325 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-4500
(706) 653-6841
(706) 653-7843
Mailing address
2325 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-4500
(706) 653-6841
(706) 653-7843

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009409
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003213855A
GA
Enumeration date
01/24/2018
Last updated
07/28/2020
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