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Provider Information for 1346590213


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Ms. ALISA SPANN PRICE LPC


Sex: Female

NPI: 1346590213
Last Updated: 2012-09-18
Certification Date:

Details

NameValue
NPI1346590213
Enumeration Date2012-09-18
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1120 W BROAD AVE
SUITE C-6
ALBANY, GA 31707-4397
United States

Phone: 229-430-0416 | Fax:229-430-6002
 
Primary Practice Address 12799 MAGNOLIA ST
BLAKELY, GA 39823-2315
United States

Phone: 229-430-0416 | Fax:229-430-6200
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalGALPC006733