Individual
MS. DOREEN R CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4530 S BERKELEY LAKE RD, STE B, BERKELEY LAKE, GA 30071-1657
(678) 662-0029
(770) 446-5643
Mailing address
4530 S BERKELEY LAKE RD, STE B, BERKELEY LAKE, GA 30071-1657
(678) 662-0029
(770) 446-5643
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006026
GA
Other
Enumeration date
04/10/2017
Last updated
06/29/2017
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