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Individual

MS. MARTHA VECKER MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1900 TREE MOUNTAIN PKWY, STONE MOUNTAIN, GA 30083-6711
(706) 994-6588

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004237
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CSW004237
LICENSE
GA
Enumeration date
08/06/2013
Last updated
12/26/2019
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