Provider Demographics
NPI:1083986038
Name:DRIGGERS, RONNA ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:RONNA
Middle Name:ANNE
Last Name:DRIGGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CAMELLIA DR
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6578
Mailing Address - Country:US
Mailing Address - Phone:706-836-1298
Mailing Address - Fax:
Practice Address - Street 1:130 CAMELLIA DR
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6578
Practice Address - Country:US
Practice Address - Phone:706-836-1298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007448101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000606317BMedicaid
GA000606317BMedicaid