Individual
ALACE STORM BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
486 LINDBERGH PL NE APT 323, ATLANTA, GA 30324-3351
(404) 973-8170
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW008906
GA
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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