Individual
KELLY L MENDIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
523 1/2 PRINCE AVE, ATHENS, GA 30601-2450
(706) 425-8900
(706) 425-8600
Mailing address
523 1/2 PRINCE AVE, ATHENS, GA 30601-2450
(706) 425-8900
(706) 425-8600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004270
GA
Other
Enumeration date
03/01/2010
Last updated
06/03/2010
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