Individual
MRS. MARCY A STIDUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
153 INDEPENDENCE DR, CARROLLTON, GA 30116-9000
(770) 836-6678
(770) 836-2266
Mailing address
122 GORDON COMMERCIAL DR # C, LAGRANGE, GA 30240-5740
(706) 845-4045
(706) 845-4312
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003490
GA
Other
Enumeration date
09/15/2006
Last updated
10/17/2007
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