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104 Greene St Augusta GA 30901-1609 | |
| (762) 585-4610 | |
| (708) 884-1454 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 104 Greene St, Augusta, Georgia |
| Authorized Official Name and Position | Natalie Bryan (DIRECTOR) |
| Authorized Official Contact | 5166108720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2140 Reserve Ln Augusta GA 30907-6218 Ph: (516) 610-8720 | 104 Greene St Augusta GA 30901-1609 Ph: (762) 585-4610 |
| NPI Number | 1205394160 |
|---|---|
| Provider Enumeration Date | 03/08/2019 |
| Last Update Date | 11/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205394160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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