Organization
SOUTHEAST PERINATAL COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL WILSON LCSW (THERAPIST)
(678) 404-9886
Entity
Organization
Contact information
Practice address
1450 NEWNAN CROSSING BLVD E APT 4213, NEWNAN, GA 30265-0010
(678) 404-9886
Mailing address
388 BULLSBORO DR # 301, NEWNAN, GA 30263-1069
(678) 404-9886
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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