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1871181974
MAXINE JEAN DOUGLAS
BROOKHAVEN, GA
NPI
1871181974
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Former Name
MAXINE JEAN ZANDIEH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: GA CSW005840)
Enumeration Date
2021-01-05
Last Update Date
2021-01-05
Business Address
MAXINE JEAN DOUGLAS LCSW
10 PERIMETER SUMMIT BLVD NE UNIT 4408
BROOKHAVEN, GA 30319-1487
Phone number: 404-468-3284
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Mailing Address
MAXINE JEAN DOUGLAS LCSW
10 PERIMETER SUMMIT BLVD NE UNIT 4408
BROOKHAVEN, GA 30319-1487
Phone number: 404-468-3284
Copy
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