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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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