Provider Demographics
NPI:1467469601
Name:CLIFT, JOE WALTER (MFT)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:WALTER
Last Name:CLIFT
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3306
Mailing Address - Country:US
Mailing Address - Phone:229-446-1222
Mailing Address - Fax:229-436-5042
Practice Address - Street 1:1908 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3306
Practice Address - Country:US
Practice Address - Phone:229-446-1222
Practice Address - Fax:229-436-5042
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA874174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist