Individual
KELLIE MARIE MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(706) 855-1446
Mailing address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(706) 855-1446
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10021
SC
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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