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Individual

CASSONIA HENLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3643 WALTON WAY EXT BLDG 4, AUGUSTA, GA 30909-6677
(706) 364-1404
Mailing address
2701 WOODCREST DR APT H, AUGUSTA, GA 30909-0413
(706) 814-0869

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/06/2021
Last updated
05/06/2021
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