Individual
ANGELICA MARIA LA LUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(706) 364-1404
(706) 364-1419
Mailing address
3643 WALTON WAY EXTENSION, AUGUSTA, GA 30909-4507
(706) 364-1404
(706) 364-1419
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004211
GA
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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