Individual
JANIE MARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3 PARK LN NE, APT H, ATLANTA, GA 30309
(802) 345-1234
Mailing address
3 PARK LN NE APT H, ATLANTA, GA 30309-3358
(802) 345-1234
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW006003
GA
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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