Self-Soulstice, LLC
NPI #1477959807 in Statesboro, Georgia
Provider Information
- NPI Number
- 1477959807
- Entity Type
- Organization
- Organization Name
- Self-Soulstice, LLC
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Nov 12, 2014
- Last Updated
- Nov 12, 2014
Practice Location
- Address
- 114 N COLLEGE ST
- City
- Statesboro
- State
- Georgia
- ZIP Code
- 30458-5309
- Phone
- (912) 755-7069
Authorized Official
- Name
- DR. D DIONNE BATES, PHD
- Title
- OWNER
- Phone
- (912) 755-7069
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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