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1780250019
HANNAH ELISSA FORDHAM
VIDALIA, GA
NPI
1780250019
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA LPC012122)
Enumeration Date
2021-05-27
Last Update Date
2021-05-27
Business Address
HANNAH ELISSA FORDHAM LPC
106 E 2ND ST
VIDALIA, GA 30474-4709
Phone number: 912-585-5504
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Mailing Address
HANNAH ELISSA FORDHAM LPC
PO BOX 765
VIDALIA, GA 30475-0765
Phone number: 912-585-5504
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