Individual
MR. COLLIN J. VANDER POL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
81 CROWN MOUNTAIN PL, SUITE A-300, DAHLONEGA, GA 30533-1627
(706) 867-0566
(706) 867-6859
Mailing address
PO BOX 1693, DAHLONEGA, GA 30533-0029
(706) 867-0566
(706) 867-6859
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003570
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
448982378A
—
GA
05
—
448982378B
—
GA
Enumeration date
09/20/2006
Last updated
07/19/2012
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