| Blackbird And Cornerstone Llc | |
|
326 Myrtle Crossing Dr Statesboro GA 30458-4688 | |
| (912) 489-7590 | |
| Not Available |
| Full Name | Blackbird And Cornerstone Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 326 Myrtle Crossing Dr, Statesboro, Georgia |
| Authorized Official Name and Position | Carly Melissa Mock (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 9126189568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackbird And Cornerstone Llc 175 Pat Mock Road Statesboro GA 30458-6483 Ph: (912) 618-9568 | Blackbird And Cornerstone Llc 326 Myrtle Crossing Dr Statesboro GA 30458-4688 Ph: (912) 489-7590 |
| NPI Number | 1265251094 |
|---|---|
| Provider Enumeration Date | 10/08/2024 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265251094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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