Individual
MRS. MIRANDA JILL STAPLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
116 PIERCE AVE, MACON, GA 31204-2891
(478) 464-3010
Mailing address
116 PIERCE AVE, MACON, GA 31204-2891
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW002687
GA
1041C0700X
Clinical Social Worker
Primary
CSW004757
GA
Other
Enumeration date
05/22/2008
Last updated
03/18/2015
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