Individual
DONNA BRUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3750 PALLADIAN VILLAGE DR, SUITE 100, MARIETTA, GA 30066-8200
(678) 492-1008
Mailing address
2223 LASALLE DR, MARIETTA, GA 30062-8149
(678) 492-1008
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003290
GA
Other
Enumeration date
02/21/2007
Last updated
09/11/2007
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