Individual
ALEXIA D. FAGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5575
(706) 596-5589
Mailing address
2100 COMER AVE, COLUMBUS, GA 31904-8725
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000X
GA
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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