Individual
MRS. ANGILIA EGBOSIMBAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1916 N LEG RD, AUGUSTA, GA 30909-4402
(706) 667-4279
(706) 667-4278
Mailing address
473 OLD EVANS RD, APT 109, MARTINEZ, GA 30907-4324
(706) 750-4431
(706) 750-4432
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YS0200X
School Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000612356
—
GA
Enumeration date
04/15/2014
Last updated
04/16/2014
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