Individual
COLISHA MARIE AMOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3345 SADDLEBROOK DR, HEPHZIBAH, GA 30815
(706) 691-9688
Mailing address
2801 WASHINGTON RD STE 107 BOX 261, AUGUSTA, GA 30909-2355
(706) 691-9688
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC010193
GA
101YP2500X
Professional Counselor
Primary
LPC010193
GA
Other
Enumeration date
01/04/2020
Last updated
08/16/2021
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