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Individual

MR. GARY RONALD LESTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
176 INDIAN SPRINGS ST, JACKSON, GA 30233-2124
(678) 447-5063
(770) 775-5118
Mailing address
PO BOX1818, JACKSON, GA 30233-4164
(678) 447-5063
(770) 775-5118

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002890
GA

Other

Enumeration date
04/27/2009
Last updated
04/27/2009
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