Individual
DALENA PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1943 STERLING OAKS CIR NE, BROOKHAVEN, GA 30319-4129
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW011256
GA
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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