Everett, Otha
Everett, Otha is an sole proprietor health care provider with primary practice located at 733-B Carroll Street , Perry GA 31069. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Everett, Otha can be contacted via phone (478) 224-2850.Contact Information
Primary practice address
733-B Carroll Street
Perry GA 31069
Phone: (478) 224-2850
Fax: (478) 224-2850
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 00048259 | Georgia |
Profile Details
| NPI number | 1043755531 |
|---|---|
| LBN Legal business name | Everett, Otha |
| Credentials | EDD, CRC, MHP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 20th, 2016 |
| Last updated | Dec 20th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043755531 | NPPES |
| Georgia | Other | 00048259 | PROFESSIONAL COUNSELOR |
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