Individual
MICHELLE DURRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1540 BINGHAMPTON CIR, BOGART, GA 30622-3336
(770) 312-3754
Mailing address
1540 BINGHAMPTON CIR, BOGART, GA 30622-3336
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006753
GA
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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