Individual
CARLY DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
370 CLOVER ST, ATHENS, GA 30606-2606
(678) 936-5988
Mailing address
370 CLOVER ST, ATHENS, GA 30606-2606
(678) 936-5988
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007797
GA
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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