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1144757659
MARY STACK
PEACHTREE CORNERS, GA
NPI
1144757659
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CSW004583)
Enumeration Date
2017-05-15
Last Update Date
2017-05-15
Business Address
MARY STACK LCSW
6624 JIMMY CARTER BLVD STE A
PEACHTREE CORNERS, GA 30071-1727
Phone number: 770-743-0004
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Mailing Address
MARY STACK LCSW
3497 TULIP TREE LN
DULUTH, GA 30096-5332
Phone number: 678-234-3685
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