Individual
EDWARD MIGUEL VALENTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
126 ENTERPRISE PATH STE 104B, HIRAM, GA 30141-2655
(770) 256-7078
Mailing address
196 BANYON CT, DALLAS, GA 30157-5104
(678) 744-8336
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004884
GA
Other
Enumeration date
04/25/2013
Last updated
11/04/2019
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