Individual
STEPHANIE KILLENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
198 S MACARTHUR DR, CAMILLA, GA 31730-6370
(229) 336-2247
Mailing address
603 GILBERT LN, ALBANY, GA 31701-5416
(229) 291-5855
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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