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Individual

SANDRA JULIANA BRAVO-PATINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
5231 FREMONT CT SW, STONE MOUNTAIN, GA 30087-3240
(678) 368-9623
Mailing address
5231 FREMONT CT SW, STONE MOUNTAIN, GA 30087-3240
(678) 368-9623

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004897
GA

Other

Enumeration date
03/05/2014
Last updated
03/05/2014
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