Individual
MRS. LATOYA GRANDY-WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1805 OVER LAKE DR SE STE D, CONYERS, GA 30013
(770) 572-5991
Mailing address
1805 OVER LAKE DR SE STE D, CONYERS, GA 30013-1790
(770) 572-5991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005086
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003160476B
—
GA
Enumeration date
03/12/2014
Last updated
10/09/2018
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