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1184045767
CHASE JACKSON GODWIN
VALDOSTA, GA
NPI
1184045767
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: GA LPC007195)
Enumeration Date
2013-12-26
Last Update Date
2013-12-26
Business Address
MR. CHASE JACKSON GODWIN LPC
3903 TROTTERS RIDGE CIR
VALDOSTA, GA 31605-4894
Phone number: 912-288-4880
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Mailing Address
MR. CHASE JACKSON GODWIN LPC
3903 TROTTERS RIDGE CIR
VALDOSTA, GA 31605-4894
Phone number: 912-288-4880
Copy
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