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General NPI Number Information
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NPI Number | 1013741941
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Entity Type | Organization
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Legal Business Name | HOPE, FAITH AND RESILIENCE COUNSELING
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Dates
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Enumeration Date | 09/02/2024
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 1415 JORDAN DR
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City | STATESBORO
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State | GA
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Zip | 30458-2465
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Country | US
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Telephone | 912-541-4968
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 JORDAN DR
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City | STATESBORO
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State | GA
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Zip | 30458-2465
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Country | US
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Telephone | 912-541-4968
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | KRISTINA BREWTON
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Credential |
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Telephone | 912-541-4968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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