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General NPI Number Information
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NPI Number | 1730889593
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Entity Type | Organization
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Legal Business Name | SOWEGA AUTISM & PSYCHIATRY
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 1909 ABERDEEN RD STE 104
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City | ALBANY
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State | GA
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Zip | 31701-1300
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Country | US
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Telephone | 229-800-5547
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Fax | 229-800-5548
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Provider Business Mailing Address
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Address Line | 4804 GRANDVIEW DR
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City | ALBANY
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State | GA
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Zip | 31721-9426
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Country | US
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Telephone | 229-869-2584
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Fax | 229-800-5548
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Authorized Official
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Title or Position | OWNER
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Name | FLORA I JONES
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Credential | FNP-BC, PMHNP-BC
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Telephone | 229-869-2584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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