Provider Demographics
NPI:1437935335
Name:JEFFREYS, GEORGIA BRENTENEY
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:BRENTENEY
Last Name:JEFFREYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 GABLE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-2913
Mailing Address - Country:US
Mailing Address - Phone:800-244-4870
Mailing Address - Fax:
Practice Address - Street 1:2370 GABLE RD
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-2913
Practice Address - Country:US
Practice Address - Phone:800-244-4870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional