Individual
MRS. MADELINE DIANE CHRESTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4485 TENCH RD STE 1220, SUWANEE, GA 30024-6742
(770) 378-6835
Mailing address
4485 TENCH RD STE 1220, SUWANEE, GA 30024-6742
(770) 378-6835
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CSW004747
GA
104100000X
Social Worker
MSW004739
GA
1041C0700X
Clinical Social Worker
Primary
CSW004747
GA
Other
Enumeration date
07/06/2012
Last updated
12/19/2017
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