Individual
MS. GWYNN S COLVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1505 MEADOWS LN, VIDALIA, GA 30474-4424
(912) 403-1544
Mailing address
1505 MEADOWS LN, VIDALIA, GA 30474-4424
(912) 403-1544
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
006222
GA
Other
Enumeration date
05/22/2007
Last updated
12/27/2016
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