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General NPI Number Information
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NPI Number | 1629138862
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Entity Type | Individual
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Provider Name | MABLE DEVON ATKINS MSW
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 41ST STREET BUILDING 40701
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City | FT. GORDON
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-787-5047
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Fax |
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Provider Business Mailing Address
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Address Line | 4589 HARDY MCMANUS RD
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City | EVANS
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State | GA
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Zip | 30809-5021
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Country | US
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Telephone | 706-855-6578
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Fax | 706-787-8180
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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 | 6801077769
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License Number State | MI
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