Healthcare Provider Details
I. General information
NPI: 1255319257
Provider Name (Legal Business Name): CLAUDIA DEMME PLUTA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 01/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3400 OLD MILTON PKWY SUITE 535
ALPHARETTA GA
30005-3707
US
IV. Provider business mailing address
1872 MONTREAL RD
TUCKER GA
30084-5709
US
V. Phone/Fax
- Phone: 678-566-6995
- Fax: 678-566-0346
- Phone: 770-496-9400
- Fax: 770-496-9495
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | CSW002467 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: