Individual
JIMMIE DENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
894 KEMP RD, LA FAYETTE, GA 30728-5016
(423) 991-0034
Mailing address
501 MIZE ST, LA FAYETTE, GA 30728-3346
(423) 991-0034
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Enumeration date
12/07/2019
Last updated
12/07/2019
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