Jo-Anna Elizabeth Boutwell
Counselor in Vidalia, GA. Individual provider (NPI-1).
NPI number1023902012
StatusActive
Last updated in NPPESJun 5, 2025
Details
- NPI
- 1023902012
- Entity type
- Individual (NPI-1)
- Name
- Jo-Anna Elizabeth Boutwell
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 5, 2025
- Certification date
- Jun 5, 2025
- Last updated
- Jun 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | MFT002127 | GA | Yes |
Practice location
204 Durden StVidalia, GA 30474-4608
Phone 912-253-6595
Mailing address
204 Durden StVidalia, GA 30474-4608
Phone 912-253-6595
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