Individual
LISA DANIELLE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5400 LAUREL SPRINGS PKWY, SUITE 1101, SUWANEE, GA 30024-6056
(678) 908-5543
Mailing address
5400 LAUREL SPRINGS PKWY, SUITE 1101, SUWANEE, GA 30024-6056
(678) 908-5543
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003314
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220143218A
—
GA
Enumeration date
11/15/2006
Last updated
04/29/2008
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