Individual
EMORY MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2530 SANDCREST BLVD, COLUMBUS, IN 47203-3047
(812) 372-3177
(812) 372-3692
Mailing address
2530 SANDCREST BLVD, COLUMBUS, IN 47203-3047
(812) 372-3177
(812) 372-3692
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000234A
IN
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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