Individual
NICOLE CHRISTINE CONVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
2222 HILL ST NW, ATLANTA, GA 30318-4717
(770) 842-2084
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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