Individual provider · Type 1 NPI

Charlesetta Willis, MHA, MS, RN

Mental Health Counselor · Martinez, GA

NPI number 1104575646 Active

Practice location

4145 Columbia Rd
Martinez, GA 30907-5400

Mailing address

860 Willow Lk
Evans, GA 30809-8000

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN219487 (GA)
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1104575646

Charlesetta Willis, MHA, MS, RN's National Provider Identifier is 1104575646, issued on Mar 22, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Martinez, GA. The record was last updated on Oct 13, 2022.