Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist |
NPI | 1194236810 |
---|---|
Provider Name | Camelle M Baynes |
First Address | Snellville, GA 30039-6494 |
Second Address | Snellville, GA 30039-6494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2017 |
Last Update Date | 06/03/2019 |