Individual
ADAM FAZILAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHPA
Contact information
Practice address
104 HAYDEN DR, SAINT MARYS, GA 31558-1108
(904) 738-3796
Mailing address
104 HAYDEN DR, SAINT MARYS, GA 31558-1108
(904) 738-3796
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/04/2025
Last updated
12/04/2025
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