Individual
MRS. MARLA ROUNTREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3310 BEMISS RD, VALDOSTA, GA 31605-7014
(229) 586-6082
(229) 922-9374
Mailing address
3310 BEMISS RD, VALDOSTA, GA 31605-7014
(222) 232-4833
(877) 343-0538
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
007316
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548705031
BLUE CROSS BLUE SHIELD/ANTHEM
GA
Enumeration date
06/10/2013
Last updated
06/11/2024
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