Individual
HANNAH ELISSA FORDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
106 E 2ND ST, VIDALIA, GA 30474-4709
(912) 585-5504
(912) 525-3026
Mailing address
PO BOX 765, VIDALIA, GA 30475-0765
(912) 585-5504
(912) 525-3026
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC012122
GA
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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