Provider Demographics
NPI:1316215775
Name:PERRY, ANNETTE O (LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:O
Last Name:PERRY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 338
Mailing Address - Street 2:7 ST. ANDREWS CT.
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31521
Mailing Address - Country:US
Mailing Address - Phone:912-267-0774
Mailing Address - Fax:912-267-9552
Practice Address - Street 1:4019 HWY 40 EAST
Practice Address - Street 2:
Practice Address - City:ST. MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558
Practice Address - Country:US
Practice Address - Phone:912-267-0774
Practice Address - Fax:912-267-9552
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003293101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional