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General NPI Number Information
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NPI Number | 1184822967
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Entity Type | Individual
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Provider Name | DAWNA WYDRA DRURY LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 5400 LAUREL SPRINGS PKWY STE. 1101
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City | SUWANEE
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State | GA
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Zip | 30024-6056
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Country | US
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Telephone | 470-239-3651
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 THUNDER GULCH PASS
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City | SUWANEE
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State | GA
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Zip | 30024-5444
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Country | US
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Telephone | 678-613-5384
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW002146
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License Number State | GA
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