Organization
GROWTH THERAPY
Active
Organization
GROWTH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEIGH ELLEN WATTS-MAGNESS LCSW (SOLE MEMBER)
(888) 283-2780
Entity
Organization
Contact information
Practice address
1 HUNTINGTON RD, #105, ATHENS, GA 30606-7204
(888) 307-2780
(888) 283-8780
Mailing address
1 HUNTINGTON RD, #105, ATHENS, GA 30606-7204
(888) 307-2780
(888) 283-8780
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004116
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339198135A
—
GA
Enumeration date
09/27/2012
Last updated
09/27/2012
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