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Individual

MRS. MUTALE PAULINE BINGLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1515 RIVER PL STE 200, BRASELTON, GA 30517
(770) 848-6140
(770) 848-6141
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
399
AK
1041C0700X
Clinical Social Worker
Primary
CSW006221
GA

Other

Enumeration date
06/19/2012
Last updated
12/08/2020
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