Individual
DR. BENNIE ELGIN CALLOWAY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.MIN, DRE, LCPC
Contact information
Practice address
2206 E HILL AVE, VALDOSTA, GA 31601-0680
(229) 245-8108
Mailing address
2206 E HILL AVE, VALDOSTA, GA 31601-0680
(229) 245-8108
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
22139
FL
101YP1600X
Pastoral Counselor
Primary
22139
FL
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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