Individual
MRS. MARTHA HARRELL FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
265 ORANGE ST, MACON, GA 31201-1646
(478) 361-2601
Mailing address
265 ORANGE ST, MACON, GA 31201-1646
(478) 361-2601
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001148
GA
Other
Enumeration date
03/21/2010
Last updated
03/21/2010
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