Organization
REGINA KATHERINE WISENBAKER
Active
Other names
Wisenbaker Counseling Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REGINA KATHERINE WISENBAKER LCSW (OWNER)
(229) 630-6587
Entity
Organization
Contact information
Practice address
415 COWART AVE STE B, VALDOSTA, GA 31602-2651
(229) 630-6587
(229) 257-0757
Mailing address
415 COWART AVE STE B, VALDOSTA, GA 31602-2651
(229) 630-6587
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
CSW005046
GA
Other
Enumeration date
01/16/2014
Last updated
04/09/2014
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