Individual provider · Type 1 NPI
Coresa Hawanis Thomas, C&A CLINICIAN
Mental Health Counselor · Walton, GA
NPI number
1558968149
Active
Practice location
Advantage Behavioral Health, 384 State Hwy 11 SW
Walton, GA 30655
Fax (770) 207-4167
Mailing address
621 Holly Springs Ct
Athens, GA 30606-0787
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
About NPI 1558968149
Coresa Hawanis Thomas, C&A CLINICIAN's National Provider Identifier is 1558968149, issued on Oct 6, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Walton, GA. The record was last updated on Oct 6, 2020.