Organization
IN DEPTH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERRY MALCOLM LCSW (OWNER)
(706) 201-9112
Entity
Organization
Contact information
Practice address
485 HUNTINGTON RD STE 197, ATHENS, GA 30606-1845
(706) 201-9112
Mailing address
135 GREENCREST DR, ATHENS, GA 30605-3825
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002504
GA
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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