Individual
GINA MARIE DEFALCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
485 HUNTINGTON RD, STE 201, ATHENS, GA 30606-1845
(706) 546-8440
(706) 546-8456
Mailing address
485 HUNTINGTON RD, STE 201, ATHENS, GA 30606-1845
(706) 546-8440
(706) 546-8456
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW002441
GA
1041C0700X
Clinical Social Worker
Primary
CSW004228
GA
Other
Enumeration date
02/22/2006
Last updated
10/17/2022
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