Individual
KELLY MARIE STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
431 LUFBERY CIR, WILLIAMSON, GA 30292-3423
(770) 310-3047
Mailing address
197 WADDELL RD, WOODBURY, GA 30293-4033
(770) 841-3975
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW003940
GA
1041C0700X
Clinical Social Worker
Primary
CSW004930
GA
Other
Enumeration date
06/21/2011
Last updated
04/23/2024
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