Individual
MADISON SHAE MULLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1093 CLEVELAND AVE, ATLANTA, GA 30344-6740
(404) 768-2218
Mailing address
4364 MILFORD PL, HOSCHTON, GA 30548-1674
(502) 370-7532
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW010296
GA
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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