| The Mindspring Center | |
|
1147 Us Highway 80 W Pooler GA 31322-2203 | |
| (912) 748-6463 | |
| (912) 748-1507 |
| Full Name | The Mindspring Center |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1147 Us Highway 80 W, Pooler, Georgia |
| Authorized Official Name and Position | Jennifer Ann Ranicki (OWNER) |
| Authorized Official Contact | 9127486463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Mindspring Center 1147 Us Highway 80 W Pooler GA 31322-2203 Ph: (912) 748-6463 | The Mindspring Center 1147 Us Highway 80 W Pooler GA 31322-2203 Ph: (912) 748-6463 |
| NPI Number | 1609307834 |
|---|---|
| Provider Enumeration Date | 03/21/2017 |
| Last Update Date | 03/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609307834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC006682 (Georgia) | Primary |
| 101YP2500X | Counselor - Professional | APC005533 (Georgia) | Secondary |
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