Individual
GINA N FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
272 S. COLUMBIA AVE, RINCON, GA 31326
(912) 658-5392
Mailing address
PO BOX 2045, RINCON, GA 31326-2045
(912) 658-5392
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4076
GA
Other
Enumeration date
01/10/2007
Last updated
11/25/2008
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