Individual
MARY ALICE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
875 HIGHWAY 82 S, JEFFERSON, GA 30549-5779
(706) 351-9835
Mailing address
875 HIGHWAY 82 S, JEFFERSON, GA 30549-5779
(706) 351-9835
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
CN0030054372
GA
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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