Individual
MRS. KIMLEY MAIENZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1827 POWERS FERRY RD SE, BLDG 24, SUITE 300, ATLANTA, GA 30339-5621
(770) 818-0070
(770) 818-0068
Mailing address
1080 RIVER PLANTATION DR, WOODSTOCK, GA 30188-2387
(678) 494-0999
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000740
GA
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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