Individual
GERALDINE H ENCARNACION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8765 HOPEWELL RD, LIZELLA, GA 31052-3816
(478) 305-1703
Mailing address
8765 HOPEWELL RD, LIZELLA, GA 31052-3816
(478) 305-1703
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
GA
101YP1600X
Pastoral Counselor
—
OH
101YP1600X
Pastoral Counselor
—
VI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-15939-IL
COMMERCIAL LICENSE
VI
Enumeration date
01/16/2021
Last updated
01/16/2021
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