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1619002003
JOHN STEPHEN AUTRY
BLACKSHEAR, GA
NPI
1619002003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: GA MFT000386)
Enumeration Date
2007-02-23
Last Update Date
2007-07-08
Business Address
-- JOHN STEPHEN AUTRY
901 COLLEGE AVE
BLACKSHEAR, GA 31516
Phone number: 912-449-2714
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Mailing Address
-- JOHN STEPHEN AUTRY
901 COLLEGE AVENUE
BLACKSHEAR, GA 31516
Phone number: 912-449-2714
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