Organization
PHOENIX BEHAVIORAL HEALTH SERVICE OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NYLA P BOWENS LPC (THERAPIST/PROFESSIONAL COUNSELOR)
(770) 478-3417
Entity
Organization
Contact information
Practice address
8712 TARA BLVD, JONESBORO, GA 30236-4905
(770) 478-3417
(770) 478-3419
Mailing address
8712 TARA BLVD, JONESBORO, GA 30236-4905
(770) 478-3417
(770) 478-3419
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC000247
GA
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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