Individual
MRS. ALISSA ELAINE WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1212 BAILING DR, LAWRENCEVILLE, GA 30043-5296
(770) 595-4023
Mailing address
1212 BAILING DR, LAWRENCEVILLE, GA 30043-5296
(770) 595-4023
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004000
GA
Other
Enumeration date
08/22/2008
Last updated
01/26/2009
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