Individual
JACOB SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
9249 HIGHWAY 29 S, ATHENS, GA 30601-6352
(706) 227-4534
Mailing address
9249 HIGHWAY 29 S, ATHENS, GA 30601-6352
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW008283
GA
Other
Enumeration date
06/14/2021
Last updated
11/01/2022
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