Individual
CARLY MARIE FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
110 HIDDEN LAKE CIR, CANTON, GA 30114-1233
(678) 878-0782
Mailing address
110 HIDDEN LAKE CIR, CANTON, GA 30114-1233
(678) 878-0782
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007035
GA
1041C0700X
Clinical Social Worker
SW16900
FL
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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