Provider Demographics
NPI:1891531752
Name:CHALFA, EUGENIA
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:
Last Name:CHALFA
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 1:4683 WESLEYAN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4408
Mailing Address - Country:US
Mailing Address - Phone:404-387-6338
Mailing Address - Fax:
Practice Address - Street 1:402 OSIGIAN BLVD STE 400
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8992
Practice Address - Country:US
Practice Address - Phone:478-333-3058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008482101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor