Individual
CARLY MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27 S MAIN ST, STATESBORO, GA 30458-5245
(912) 225-3769
Mailing address
PO BOX 1242, STATESBORO, GA 30459-1242
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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