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Juanita Davis, LCSW

Counselor, Mental Health in Lawrenceville, GA. Individual provider (NPI-1).

NPI number1508301458
StatusActive
Last updated in NPPESJan 2, 2017

Details

NPI
1508301458
Entity type
Individual (NPI-1)
Name
Juanita Davis
Credential
LCSW
Sex
Female
Sole proprietor
No
Enumeration date
Jan 2, 2017
Last updated
Jan 2, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthCSW003751GAYes
101Y00000X CounselorCSW003751GA

Practice location

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Phone 678-209-2394

Mailing address

2910 Monticello Pl
Decatur, GA 30030-4613

Phone 678-680-9558

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