Individual
ANNA CHARLOTTE CHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
410 E CHURCH ST, FORT VALLEY, GA 31030-3097
(229) 815-5454
Mailing address
122 W FORSYTH ST, AMERICUS, GA 31709-3561
(229) 815-5454
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
GA
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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