Individual
CHRYSTAL WASDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2009 HIWASSEE DR, BONAIRE, GA 31005-2509
(478) 953-5618
Mailing address
2009 HIWASSEE DR, BONAIRE, GA 31005-2509
(478) 953-5618
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
007231
GA
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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