Individual
KACEY GAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
209 S COLLEGE ST, STATESBORO, GA 30458-5255
(912) 764-1817
(912) 764-7623
Mailing address
209 S COLLEGE ST, STATESBORO, GA 30458-5255
(912) 764-1817
(912) 764-7623
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008582
GA
Other
Enumeration date
03/10/2016
Last updated
03/10/2016
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