Organization
KIM WASLEY LCSW LLC
Active
Other names
Kim Wasley, LCSW, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WASLEY LCSW (OWNER)
(706) 974-9065
Entity
Organization
Contact information
Practice address
598 S MILLEDGE AVE STE 5, ATHENS, GA 30605-1262
(706) 522-3017
Mailing address
196 ALPS RD, SUITE 2, PMB 196, ATHENS, GA 30606
(706) 974-9065
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598239964
—
GA
Enumeration date
07/30/2024
Last updated
07/30/2024
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