Individual
MIRANDA ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
600 COASTAL VILLAGE DR, BRUNSWICK, GA 31520-1973
(125) 548-5009
Mailing address
124 SW BROAD ST, JESUP, GA 31545-1100
(912) 280-7023
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007201
GA
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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