Individual
BILLY GLENN WILBORN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6600 VAN AALST BLVD BLDG 9250, FORT BENNING, GA 31905-2102
(706) 544-8674
Mailing address
5431 ROYAL ST, COLUMBUS, GA 31907-6157
(706) 442-6297
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009659
GA
Other
Enumeration date
03/03/2018
Last updated
03/03/2018
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