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General NPI Number Information
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NPI Number | 1962715490
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Entity Type | Individual
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Provider Name | JEWEL ABIGALE SEARLES LAPC
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Gender | Female
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 07/27/2012
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Provider Practice Location Address
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Address Line | 228 MILLSTONE DR
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City | HAMPTON
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State | GA
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Zip | 30228-4810
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Country | US
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Telephone | 518-892-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 228 MILLSTONE DR
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City | HAMPTON
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State | GA
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Zip | 30228-4810
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Country | US
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Telephone | 518-892-6258
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | APC002337
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC006334
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License Number State | GA
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