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Individual

MR. JOSEPH WILLIAM WITHERSPOON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
977A TAYLOR ST SW, CONYERS, GA 30012-5357
(770) 918-6677
Mailing address
977A TAYLOR ST SW, CONYERS, GA 30012-5357
(770) 918-6677

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW003115
GA

Other

Enumeration date
07/11/2011
Last updated
07/11/2011
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