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General NPI Number Information
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NPI Number | 1396097515
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Entity Type | Individual
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Provider Name | CYNTHIA BEASLEY DRIGGERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 01/06/2015
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Provider Practice Location Address
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Address Line | 641 SPRING ST SE
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City | GAINESVILLE
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State | GA
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Zip | 30501-3741
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Country | US
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Telephone | 706-878-6011
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Fax |
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Provider Business Mailing Address
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Address Line | 641 SPRING ST SE
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City | GAINESVILLE
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State | GA
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Zip | 30501-3741
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Country | US
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Telephone | 706-878-6011
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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 | CSW004461
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License Number State | GA
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