Individual
SAMANTHA KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
(404) 486-9034
Mailing address
136 MARSHALL FULLER RD, DALLAS, GA 30157-6133
(317) 914-4349
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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