Individual
MARY MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
383 GENERAL JACKSON DR, JEFFERSON, GA 30549-2909
(706) 389-6789
Mailing address
250 NORTH AVE, ATHENS, GA 30601-2244
(706) 389-6789
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MSW005777
GA
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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