Healthcare Provider Details

I. General information

NPI: 1659249720
Provider Name (Legal Business Name): CHRISTINA E VRANDOPULO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2935 N ASHLEY ST BLDG F
VALDOSTA GA
31602-1777
US

IV. Provider business mailing address

2935 N ASHLEY ST BLDG F
VALDOSTA GA
31602-1777
US

V. Phone/Fax

Practice location:
  • Phone: 229-333-2273
  • Fax: 229-506-5403
Mailing address:
  • Phone: 229-333-2273
  • Fax: 229-506-5403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT002237
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: