Individual
JENNIFER CYNTHIA PROSPERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
675 TEAGUE DR NW, KENNESAW, GA 30152-3752
(305) 505-3604
Mailing address
675 TEAGUE DR NW, KENNESAW, GA 30152-3752
(305) 505-3604
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007496
GA
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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