Individual
KAREN GUDGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
317 CREEKSTONE RDG, WOODSTOCK, GA 30188-3745
(770) 516-7138
(770) 516-3018
Mailing address
317 CREEKSTONE RDG, WOODSTOCK, GA 30188-3745
(770) 516-7138
(770) 516-3018
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1455
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58202790430188A003
TRICARE
GA
Enumeration date
12/27/2006
Last updated
07/18/2007
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