Individual
MR. TOMMIE LAURICE WALTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
188 S MILLEDGE AVE, SUITE 2, ATHENS, GA 30605
(706) 369-0970
(706) 353-1943
Mailing address
PO BOX 7392, 188 S MILLEDGE AVE, ATHENS, GA 30604
(706) 369-0970
(706) 553-1943
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
000692
GA
104100000X
Social Worker
LCSW 499
WY
Other
Enumeration date
01/09/2006
Last updated
07/08/2007
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