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Vanessa Mixon
Professional Counselor in Pooler, Georgia
NPI 1538700752

Vanessa Mixon is a Professional Counselor based in Pooler, GA and is specialized in Professional. Vanessa Mixon practices in Pooler, GA. The NPI Number for Vanessa Mixon is 1538700752 and holds a License No. 010156 (Georgia).

The current practice location address for Vanessa Mixon is 138 Canal St Ste 506, Pooler, GA and can be reached out via phone at 912-421-1890.

Location: 138 Canal St Ste 506, Pooler, GA, 31322-4049
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538700752
Provider Name
Vanessa Mixon
Credential
Provider Entity Type
Individual
Gender
Female
Address
138 Canal St Ste 506, Pooler, GA, 31322-4049
Phone Number
912-421-1890
Fax Number
Provider Enumeration Date
09/30/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
010156 01 GA LICENSE
institution
Provider Business Practice Location Address Details
Address
138 Canal St Ste 506
City
Pooler
State
Georgia
Zip
31322-4049
Phone Number
912-421-1890
Fax Number
person
Provider Business Mailing Address Details
Address
138 Canal St Ste 506
City
Pooler
State
Georgia
Zip
31322-4049
Phone Number
912-421-1890
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
010156 (Georgia)
Definition
Definition to come...
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