Individual
CHARLENE SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1495 DULUTH HWY STE F, LAWRENCEVILLE, GA 30043-5143
(321) 352-9187
Mailing address
116 CHASE LANDING DR, LOGANVILLE, GA 30052-6523
(321) 352-9187
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9693
CT
104100000X
Social Worker
MSW012018
GA
1041C0700X
Clinical Social Worker
Primary
CSW03862
RI
164W00000X
Licensed Practical Nurse
5260842
FL
Other
Enumeration date
07/03/2024
Last updated
09/15/2024
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