Individual
DR. CLARISSA JO MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.H.D., M.ED.
Contact information
Practice address
4040 PINNACLE WAY, HEPHZIBAH, GA 30815-6135
(863) 329-2510
Mailing address
4040 PINNACLE WAY, HEPHZIBAH, GA 30815-6135
(863) 329-2510
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
103K00000X
Behavior Analyst
—
—
171000000X
Military Health Care Provider
—
—
1744R1102X
Research Study Specialist
—
—
251300000X
Local Education Agency (LEA)
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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