Provider Information for 1700976776
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MARY PALMER LCSW
Other Names:Other Name:MARY BRUNTSex: Female
NPI: 1700976776
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1700976776 | ||||||||
| Enumeration Date | 2006-10-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3188 ATLANTA ROAD SMYRNA, GA 30080 United States Phone: 770-319-6000 | Fax:770-319-6330 | ||||||||
| Primary Practice Address | 3188 ATLANTA ROAD SMYRNA, GA 30080 United States Phone: 770-319-6000 | Fax:770-319-6330 | ||||||||
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