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Organization

DONNA BRUCKNER, LCSW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DONNA BRUCKNER L.C.S.W. (OWNER/CLINICAL SOCIAL WORKER)
(770) 645-6393
Entity
Organization

Contact information

Practice address
4321 ATLANTA ST, POWDER SPRINGS, GA 30127-2672
(770) 943-8277
Mailing address
2223 LASALLE DR, MARIETTA, GA 30062-8149
(770) 645-6393

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003290
GA

Other

Enumeration date
09/10/2009
Last updated
09/10/2009
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