Individual
LATRELL R FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4412 LIBERTY PARKWAY, SAVANNAH, GA 31405-3732
(912) 441-4954
Mailing address
2714 RYALS ST, SAVANNAH, GA 31405-1537
(912) 844-2159
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC011211
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC011211
STATE LICENSE
GA
Enumeration date
10/25/2019
Last updated
02/23/2024
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