Doctor Name: | MS. ALISA SPANN PRICE |
NPI Number: | 1346590213 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC006733 |
Business Practice Address: | 12799 Magnolia St Blakely, GA - 398232315 |
Business Phone Number: | 2294300416 |
Business Fax Number: | 2294306200 |
Mailing Address: | 1120 W Broad Ave, Suite C-6 ALBANY |
State: | GA |
Postal Code: | 317074397 |
Phone Number: | 2294300416 |
Fax Number: | 2294306002 |
NPI Enumeration Date: | 09/18/2012 |
NPI Last Update Date: | 09/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC006733 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |