NPI 1104575646

Charlesetta Willis, MHAMSRN

Practitioner Mental Health Counselor Martinez, GA

Practice location

Address: 4145 Columbia Rd, Martinez, GA 30907-5400
Phone: (706) 869-7373
Mailing address: 860 Willow Lk, Evans, GA 30809-8000

Registered specialties (2)

Mental Health Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Other Counselor providers in Georgia →

Registered Nurse

Nursing Service Providers Taxonomy 163W00000X Licence RN219487 (GA)

Other Registered Nurse providers in Georgia →

Registry record

NPI: 1104575646
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Mar 2022
Record last updated: 13 Oct 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.