Organization
MINDFUL ALTERNATIVES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAE SANSOM COLEY LCSW (LICENSED CLINICAL SOCIAL WORKER)
(678) 884-4011
Entity
Organization
Contact information
Practice address
370 LANIER AVE E, FAYETTEVILLE, GA 30214-2237
(678) 884-4011
(678) 263-8511
Mailing address
370 LANIER AVE E, FAYETTEVILLE, GA 30214-2237
(678) 884-4011
(678) 263-8511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004106
GA
Other
Enumeration date
02/06/2013
Last updated
01/22/2014
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