Individual
JULIA J WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
367 ATHENS HWY STE 1800, LOGANVILLE, GA 30052-8293
(770) 554-2999
(770) 679-6390
Mailing address
367 ATHENS HWY STE 1800, LOGANVILLE, GA 30052-8293
(770) 554-2999
(770) 679-6390
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW004942
GA
1041C0700X
Clinical Social Worker
Primary
CSW004729
GA
Other
Enumeration date
10/22/2010
Last updated
11/21/2019
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