| Empowered Mind & Wellness | |
|
805 Harmon Dr Apt B6 Valdosta GA 31601-8477 | |
| (229) 232-9601 | |
| Not Available |
| Full Name | Empowered Mind & Wellness |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 805 Harmon Dr Apt B6, Valdosta, Georgia |
| Authorized Official Name and Position | Ebonique Vernee Martin (LMFT/THERAPIST) |
| Authorized Official Contact | 2292329601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowered Mind & Wellness 805 Harmon Dr Apt B6 Valdosta GA 31601-8477 Ph: (229) 232-9601 | Empowered Mind & Wellness 805 Harmon Dr Apt B6 Valdosta GA 31601-8477 Ph: (229) 232-9601 |
| NPI Number | 1801504246 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 10/13/2023 |
| Certification Date | 10/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801504246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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