Organization
SOUTHERN BRIDGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEVA DANIELLE KNIGHT FOX LMFT (OWNER)
(478) 283-8322
Entity
Organization
Contact information
Practice address
404 CORDER RD STE 300, WARNER ROBINS, GA 31088-7195
(478) 283-8322
(877) 712-4794
Mailing address
404 CORDER RD STE 300, WARNER ROBINS, GA 31088-7195
(478) 283-8322
(877) 712-4794
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003174143A
—
GA
05
—
003209756A
—
GA
05
—
003220322A
—
GA
05
—
003222274A
—
GA
Enumeration date
07/20/2016
Last updated
09/06/2023
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