Individual
GEORGE KEVIN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
242 N MAGDALEN ST, SAN ANGELO, TX 76903-5434
(325) 944-2561
Mailing address
3830 HILLCREST DR, SAN ANGELO, TX 76904-5908
(325) 340-8960
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
50952
TX
1041C0700X
Clinical Social Worker
Primary
50952
TX
Other
Enumeration date
06/12/2009
Last updated
03/29/2011
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