Individual
JOHN STEPHEN AUTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 COLLEGE AVE, BLACKSHEAR, GA 31516
(912) 449-2714
Mailing address
901 COLLEGE AVENUE, BLACKSHEAR, GA 31516
(912) 449-2714
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT000386
GA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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