| Mnodern Ecclesia | |
|
597 San Pablo Dr Stone Mountain GA 30083-3855 | |
| (573) 479-0490 | |
| Not Available |
| Full Name | Mnodern Ecclesia |
|---|---|
| Speciality | Counselor |
| Location | 597 San Pablo Dr, Stone Mountain, Georgia |
| Authorized Official Name and Position | Willie J Singleton (DIRECTOR) |
| Authorized Official Contact | 5734479049 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mnodern Ecclesia Po Box 262 Caruthersville MO 63830-0262 Ph: (573) 497-0490 | Mnodern Ecclesia 597 San Pablo Dr Stone Mountain GA 30083-3855 Ph: (573) 479-0490 |
| NPI Number | 1952118051 |
|---|---|
| Provider Enumeration Date | 12/12/2024 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952118051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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