| Release Restore Redefine Counseling Llc | |
|
4210 Columbia Road Bldg 11, Suite A Martinez GA 30907 | |
| (706) 750-8906 | |
| Not Available |
| Full Name | Release Restore Redefine Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4210 Columbia Road, Martinez, Georgia |
| Authorized Official Name and Position | Tiffany Marie Luke (OWNER) |
| Authorized Official Contact | 7067508906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Release Restore Redefine Counseling Llc 4115 Columbia Road Suite 5 #344 Martinez GA 30907-0419 Ph: (706) 750-8906 | Release Restore Redefine Counseling Llc 4210 Columbia Road Bldg 11, Suite A Martinez GA 30907 Ph: (706) 750-8906 |
| NPI Number | 1972263465 |
|---|---|
| Provider Enumeration Date | 12/23/2021 |
| Last Update Date | 12/23/2021 |
| Certification Date | 12/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972263465 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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D. W. De Vose & Associates, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4210 Columbia Rd Ste 11b, Martinez, GA 30907 Phone: 706-364-6576 Fax: 888-445-2452 | |
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