Organization
ETHEREDGE AND SHELTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAY HILL ETHEREDGE LCSW (PRESIDENT)
(903) 277-7732
Entity
Organization
Contact information
Practice address
207 E HIRAM ST, ATLANTA, TX 75551-2661
(903) 796-5061
Mailing address
1204 HOLLY ST, ATLANTA, TX 75551-1842
(903) 796-5061
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00276
TX
1041C0700X
Clinical Social Worker
02075
TX
Other
Enumeration date
12/30/2008
Last updated
12/30/2008
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