Individual
INES LUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
410 VICTORIA STATION BLVD, LAWRENCEVILLE, GA 30043-6465
(478) 234-8510
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW005607
GA
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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