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1013249846
JESSICA DIANE ROOT
WARNER ROBINS, GA
NPI
1013249846
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: GA LPC006368)
Enumeration Date
2010-02-04
Last Update Date
2016-09-14
Business Address
Mrs. JESSICA DIANE ROOT LPCA
306 CORDER RD
WARNER ROBINS, GA 31088-3647
Phone number: 478-971-4684
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Mailing Address
Mrs. JESSICA DIANE ROOT LPCA
121 CHADWYCK LN
BONAIRE, GA 31005-3151
Phone number: 478-971-4684
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