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Individual

MRS. EVELYN CRAIG EDMONDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
44 COTTONWOOD STREET, CLAYTON, GA 30525
(706) 782-0717
(706) 782-5266
Mailing address
PO BOX 1689, CLAYTON, GA 30525-0043
(706) 782-0717
(706) 782-5266

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000924
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10045590
AMERIGROUP
GA
Enumeration date
02/07/2007
Last updated
07/09/2007
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