Individual
BETTY G YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-4858
(706) 432-3780
Mailing address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-4858
(706) 432-3780
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LPC 002863
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000606317B
—
GA
Enumeration date
10/11/2006
Last updated
07/08/2007
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