Individual
MR. MARK DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
303 FRASER DR, HINESVILLE, GA 31313-3712
(912) 877-2227
(912) 877-2332
Mailing address
178 FINN CIR, SAVANNAH, GA 31419-8408
(912) 308-6735
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW007151
GA
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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