Organization
RAW THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEQUILA SEARS LCSW (MANAGER)
(954) 294-4870
Entity
Organization
Contact information
Practice address
4827 OLD NATIONAL HWY UNIT 2223, COLLEGE PARK, GA 30337-6234
(470) 924-1792
Mailing address
3984 LAKE MANOR WAY, ATLANTA, GA 30349-8226
(954) 294-4870
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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