Individual
BRITTANY FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3754 LAVISTA RD STE 200, TUCKER, GA 30084
(404) 490-0081
Mailing address
3754 LAVISTA RD STE 200, TUCKER, GA 30084-5627
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW005840
GA
1041C0700X
Clinical Social Worker
Primary
CSW005687
GA
Other
Enumeration date
02/01/2014
Last updated
07/11/2018
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