Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | MSW007130 | GA |
NPI | 1003422353 |
---|---|
Provider Name | Mrs. Christina Marie Bell |
First Address | Lithia Springs, GA 30122-2385 |
Second Address | Marietta, GA 30060-2143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2020 |
Last Update Date | 22/09/2020 |