Individual
MARY BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 W PINE ST, COLQUITT, GA 39837-3532
(229) 758-5090
Mailing address
1120 W BROAD AVE, ALBANY, GA 31707-4397
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC001278
GA
Other
Enumeration date
08/01/2008
Last updated
08/01/2008
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