| The Center For Mindful Exploration,llc | |
|
1111 Mooty Bridge Rd Ste A Lagrange GA 30240-1742 | |
| (706) 333-2879 | |
| Not Available |
| Full Name | The Center For Mindful Exploration,llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1111 Mooty Bridge Rd Ste A, Lagrange, Georgia |
| Authorized Official Name and Position | Susan Marshall (OWNER) |
| Authorized Official Contact | 7063332879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center For Mindful Exploration,llc Po Box 800154 Lagrange GA 30240-0003 Ph: (706) 333-2879 | The Center For Mindful Exploration,llc 1111 Mooty Bridge Rd Ste A Lagrange GA 30240-1742 Ph: (706) 333-2879 |
| NPI Number | 1205324191 |
|---|---|
| Provider Enumeration Date | 04/25/2018 |
| Last Update Date | 04/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205324191 | NPI | - | NPPES |
| 618574241A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC006714 (Georgia) | Primary |
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