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General NPI Number Information
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NPI Number | 1568151488
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Entity Type | Individual
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Provider Name | RAQUEL RENEE JAMES LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/05/2023
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 115 E MAIN ST STE A1B6L
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City | BUFORD
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State | GA
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Zip | 30518-5727
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Country | US
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Telephone | 770-609-7859
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Fax |
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Provider Business Mailing Address
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Address Line | 115 E MAIN ST STE A1B6L
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City | BUFORD
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State | GA
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Zip | 30518-5727
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Country | US
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Telephone | 770-609-7859
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW008621
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License Number State | GA
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