Individual
GRIFFIN BLAKE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3815 MARHAM PARK CIR, LOGANVILLE, GA 30052-5449
(470) 412-1311
Mailing address
3815 MARHAM PARK CIR, LOGANVILLE, GA 30052-5449
(678) 468-0965
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW007450
GA
1041C0700X
Clinical Social Worker
Primary
CSW006841
GA
Other
Enumeration date
09/28/2018
Last updated
11/02/2021
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