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General NPI Number Information
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NPI Number | 1720571086
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Entity Type | Individual
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Provider Name | HILARY WOODMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 6100 LAKE FORREST DR STE 450
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City | ATLANTA
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State | GA
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Zip | 30328-3837
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Country | US
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Telephone | 770-363-1576
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Fax | 770-995-1959
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Provider Business Mailing Address
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Address Line | 6115 ABBOTTS BRIDGE RD APT 218
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City | JOHNS CREEK
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State | GA
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Zip | 30097-5753
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Country | US
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Telephone | 770-363-1576
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Fax | 770-995-1959
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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 | CSW00300
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License Number State | GA
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