Healthcare Provider Details

I. General information

NPI: 1346941457
Provider Name (Legal Business Name): KRISTI LEE MCFARLAIN-KINLAW APC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 07/31/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3506 PROFESSIONAL CIR
AUGUSTA GA
30907-8233
US

IV. Provider business mailing address

3506 PROFESSIONAL CIR
AUGUSTA GA
30907-8233
US

V. Phone/Fax

Practice location:
  • Phone: 706-210-8855
  • Fax:
Mailing address:
  • Phone: 706-210-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC009199
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: