| Empowered2change Llc | |
|
5604 Wendy Bagwell Pkwy Suite 812 Hiram GA 30141-7813 | |
| (678) 602-9709 | |
| (678) 928-9499 |
| Full Name | Empowered2change Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5604 Wendy Bagwell Pkwy, Hiram, Georgia |
| Authorized Official Name and Position | Sha-rhonda Michea Davis (OWNER) |
| Authorized Official Contact | 6786029709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowered2change Llc Po Box 1365 Hiram GA 30141-1365 Ph: (678) 602-9709 | Empowered2change Llc 5604 Wendy Bagwell Pkwy Suite 812 Hiram GA 30141-7813 Ph: (678) 602-9709 |
| NPI Number | 1548572415 |
|---|---|
| Provider Enumeration Date | 07/08/2010 |
| Last Update Date | 06/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548572415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW003415 (Georgia) | Primary |
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