Individual
MR. RICHARD BRENT WADSWORTH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAPC
Contact information
Practice address
101 QUARTZ DR STE 201, VILLA RICA, GA 30180-3256
(770) 812-3839
Mailing address
2022 DARTMOTH WAY, VILLA RICA, GA 30180-5860
(404) 829-9722
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC005998
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17844
—
GA
Enumeration date
01/19/2023
Last updated
01/19/2023
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