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Individual

MR. JACK BARNEY TAYLOR III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1617 FLAT SHOALS RD NE, MILLEDGEVILLE, GA 31061-2203
(478) 457-5883
Mailing address
1617 FLAT SHOALS RD NE, MILLEDGEVILLE, GA 31061-2203
(478) 457-5883

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
005472
GA

Other

Enumeration date
12/16/2008
Last updated
12/16/2008
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