Individual
MS. RAE SANSOM COLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
370 LANIER AVE E, FAYETTEVILLE, GA 30214-2237
(678) 884-4011
(678) 263-8511
Mailing address
370 LANIER AVE E, FAYETTEVILLE, GA 30214-2237
(678) 884-4011
(678) 263-8511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004106
GA
Other
Enumeration date
04/17/2009
Last updated
06/02/2017
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