Individual
MARY ELIZABETH KRUSAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 BIRCH RIVER CT, DALLAS, GA 30132-5575
(678) 744-8417
Mailing address
118 BIRCH RIVER CT, DALLAS, GA 30132-5575
(678) 744-8417
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW008594
GA
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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