Doctor Name: | MS. DEBRA L LILLARD |
NPI Number: | 1528297991 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W. |
License Number: | CSW001928 |
Business Practice Address: | 635 Olive Rd. Pine Lake, GA - 30072 |
Business Phone Number: | 4042861177 |
Business Fax Number: | |
Mailing Address: | Po Box 322, PINE LAKE |
State: | GA |
Postal Code: | 300720322 |
Phone Number: | 4042861177 |
Fax Number: | |
NPI Enumeration Date: | 07/07/2009 |
NPI Last Update Date: | 07/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CSW001928 |
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 |