Individual
EXTRIARA CHARLESH GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3755 REDWINE RD APT 2216, ATLANTA, GA 30344-5932
(404) 667-6791
Mailing address
3755 REDWINE RD APT 2216, ATLANTA, GA 30344-5932
(404) 667-6791
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006847
GA
Other
Enumeration date
11/23/2019
Last updated
11/23/2019
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