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NPI Profile for Dr ADELINE MCTAVOUS in SAINT MARYS, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1124341854 |
|
| Status | Active | |
| Credentials | PH.D., LPC, LMHC,CCS | |
| Entity | Individual | |
| Enumeration date | 03/09/2010 | |
| Last updated | 09/25/2018 - About 8 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ADELINE MCTAVOUS
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ADELINE MCTAVOUS, PH.D., LPC, LMHC,CCS