Doctor Name: | BELINDA DUKES EILDERS |
NPI Number: | 1972848604 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 004285 |
Business Practice Address: | 5671 Boys Ranch Rd Hahira, GA - 316322582 |
Business Phone Number: | 2292928003 |
Business Fax Number: | |
Mailing Address: | Po Box 162, HAHIRA |
State: | GA |
Postal Code: | 316320162 |
Phone Number: | 2292928003 |
Fax Number: | 2297940079 |
NPI Enumeration Date: | 12/06/2012 |
NPI Last Update Date: | 01/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 004285 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |