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Individual

DR. JOSEPH MICHAEL WOLSTENCROFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD, LPC

Contact information

Practice address
2484 INGLESIDE AVE, C-103, MACON, GA 31204-2089
(478) 746-5800
Mailing address
2484 INGLESIDE AVE, C-103, MACON, GA 31204-2089
(478) 746-5800

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1545
GA
101YM0800X
Mental Health Counselor
1545
GA
101YP2500X
Professional Counselor
1545
GA
106H00000X
Marriage & Family Therapist
1545
GA

Other

Enumeration date
04/17/2007
Last updated
06/26/2008
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