Individual
MRS. KRISTINE COLLURO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
791 VIRGINIA AVE NE, ATLANTA, GA 30306-3630
(404) 226-7536
Mailing address
881 PONCE DE LEON AVE NE, ATLANTA, GA 30306-4252
(404) 226-7536
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003413
GA
Other
Enumeration date
02/04/2013
Last updated
03/12/2013
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