Doctor Name: | ALISA DAWN STULA |
NPI Number: | 1063806610 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 3691 |
Business Practice Address: | 1551 Jennings Mill Rd Resource Valley Suite 3200 A Watkinsville, GA - 306777244 |
Business Phone Number: | 7066212548 |
Business Fax Number: | |
Mailing Address: | 1551 Jennings Mill Rd, Resource Valley Suite 3200 A WATKINSVILLE |
State: | GA |
Postal Code: | 306777244 |
Phone Number: | 7066212548 |
Fax Number: | |
NPI Enumeration Date: | 03/21/2015 |
NPI Last Update Date: | 03/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 3691 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |