Organization
BARRY J. BOUILLION JR., MA, LPC, LMFT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY JAMES BOUILLION JR. LPC, LMFT (LICENSED PROFESSIONAL COUNSELOR)
(601) 398-6797
Entity
Organization
Contact information
Practice address
3380 TRICKUM RD BLDG 700, WOODSTOCK, GA 30188-3680
(601) 398-6797
Mailing address
317 KNOTTS CIR, WOODSTOCK, GA 30188-4569
(601) 398-6797
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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