Individual
MS. KIZZY MAE WINGFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, CADC II
Contact information
Practice address
250 BRAY ST, ATHENS, GA 30601-2203
(706) 389-6789
Mailing address
375 HAWTHORNE EXT, ATHENS, GA 30606-2515
(706) 338-1046
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1440
GA
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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