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Individual

PELBA JEAN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2050 WALTON WAY, AUGUSTA, GA 30904-2305
(706) 729-5769
Mailing address
902 BURLINGTON DR, EVANS, GA 30809-4512
(706) 951-8150

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11185
SC

Other

Enumeration date
05/12/2015
Last updated
05/12/2015
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