Individual
REGINA S CLYBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
126 ENTERPRISE PATH STE 205, HIRAM, GA 30141-2654
(678) 408-1513
Mailing address
126 ENTERPRISE PATH STE 205, HIRAM, GA 30141-2654
(678) 408-1513
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC007542
GA
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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