Individual
DEBERAH LEE SLADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
347 RESOURCE PKWY, WINDER, GA 30680-8364
(770) 354-6109
(770) 995-1959
Mailing address
895 MILL CREEK RUN, SUWANEE, GA 30024-2105
(770) 354-6109
(770) 995-1959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004077
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
992898769A
MEDICAID-CMO ONLY
GA
Enumeration date
09/01/2009
Last updated
04/22/2011
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