Doctor Name: | MR. CLIFFORD ALLEN GAVIN |
NPI Number: | 1275988354 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | MSW007110 |
Business Practice Address: | 270 Carpenter Dr Ste 400 Sandy Springs, GA - 303284933 |
Business Phone Number: | 6784600345 |
Business Fax Number: | 6784600350 |
Mailing Address: | 270 Carpenter Dr Ste 400, SANDY SPRINGS |
State: | GA |
Postal Code: | 303284933 |
Phone Number: | 6784600345 |
Fax Number: | 6784600350 |
NPI Enumeration Date: | 04/26/2016 |
NPI Last Update Date: | 04/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MSW007110 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |