Individual
MARY SMITH-TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
1921 KRISTI WAY, HEPHZIBAH, GA 30815-8928
(706) 834-8852
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW .11606 LMSW
SC
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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