Provider Demographics
NPI:1134398159
Name:JAY, DELMA CHRISTINE (BSPA-CAC II)
Entity type:Individual
Prefix:MRS
First Name:DELMA
Middle Name:CHRISTINE
Last Name:JAY
Suffix:
Gender:F
Credentials:BSPA-CAC II
Other - Prefix:MRS
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:JAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSPA-CAC-AD II
Mailing Address - Street 1:403 THOROUGHBRED RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-3931
Mailing Address - Country:US
Mailing Address - Phone:912-576-7136
Mailing Address - Fax:912-576-7136
Practice Address - Street 1:104 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3803
Practice Address - Country:US
Practice Address - Phone:912-729-1120
Practice Address - Fax:912-729-1150
Is Sole Proprietor?:No
Enumeration Date:2008-02-23
Last Update Date:2008-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1882-R101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1882-ROtherSTATE BOARD CERTIFICATION