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Individual

MR. BIBI ROBERTS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
2560 RIVER RUN DR, DACULA, GA 30019-2664
(770) 513-9903

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CSW005585
GA
1041C0700X
Clinical Social Worker
Primary
CSW005585
GA

Other

Enumeration date
09/09/2015
Last updated
09/09/2015
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