Individual
MASON RICHARD PACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1811 GREEN CIR, VALDOSTA, GA 31602-2734
(864) 247-5263
Mailing address
1811 GREEN CIR, VALDOSTA, GA 31602-2734
(229) 244-9688
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
MFT001821
GA
Other
Enumeration date
04/02/2021
Last updated
11/11/2021
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