Individual
KELLY MARIE WHITMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
310 LM WIGLEY RD, DALLAS, GA 30132-1707
(167) 828-3937
Mailing address
310 LM WIGLEY RD, DALLAS, GA 30132-1707
(678) 283-9379
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003964
GA
Other
Enumeration date
01/07/2015
Last updated
02/02/2021
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