Individual
MS. LISA DATES SNODGRASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
759 BRAIDWOOD CV NW, ACWORTH, GA 30101-3544
(770) 794-6740
Mailing address
759 BRAIDWOOD CV NW, ACWORTH, GA 30101-3544
(770) 794-6740
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003232
GA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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