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Individual

PAULINE HENRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6909 MACON RD STE 27, COLUMBUS, GA 31907-0707
(706) 225-0101
(706) 225-0052
Mailing address
539 WILDER DR, COLUMBUS, GA 31907-5169
(706) 587-8986

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC008776
GA
103K00000X
Behavior Analyst
Primary
1-15-17993
GA
103K00000X
Behavior Analyst
2018-017
AL

Other

Enumeration date
03/09/2012
Last updated
03/21/2019
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