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General NPI Number Information
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NPI Number | 1447616099
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Entity Type | Organization
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Legal Business Name | CONNECTIONS FAMILY THERAPY, INC
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 1712 OSBORNE RD STE F
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City | SAINT MARYS
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State | GA
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Zip | 31558-9103
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Country | US
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Telephone | 912-510-9227
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Fax | 912-510-9228
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Provider Business Mailing Address
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Address Line | 1712 OSBORNE RD STE F
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City | SAINT MARYS
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State | GA
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Zip | 31558-9103
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Country | US
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Telephone | 912-510-9227
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Fax | 912-510-9228
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JENNIFER LYNN WILLIAMS
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Credential | LMFT
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Telephone | 912-510-9227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | GAMFT001286
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License Number State | GA
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