Individual
KERRI THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
179 PIERCE AVE, MACON, GA 31204-2821
(478) 742-1464
Mailing address
179 PIERCE AVE, MACON, GA 31204-2821
(478) 742-1464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005139
GA
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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