Individual
JOEL BAGBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 W I PKWY STE 102, DALLAS, GA 30132-5078
(770) 445-8079
Mailing address
304 W I PKWY STE 102, DALLAS, GA 30132-5078
(770) 445-8079
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001431
GA
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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