Individual
KELSEY BURNHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
409 SGODA CIR S, MACON, GA 31217-8245
(478) 714-0602
Mailing address
409 SGODA CIR S, MACON, GA 31217-8245
(478) 714-0602
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001740
GA
Other
Enumeration date
02/26/2021
Last updated
02/26/2021
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