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Mr. Bruce Walter Richardson
Mental Health Counselor in Conyers, Georgia
NPI 1467514471

Bruce Walter Richardson is a Mental Health Counselor based in Stone Mountain, GA and is specialized in Mental Health. Bruce Walter Richardson practices in Conyers, GA. The NPI Number for Bruce Walter Richardson is 1467514471 and holds a License No. (Georgia).

The current practice location address for Bruce Walter Richardson is 977 Taylor St Sw # A, Conyers, GA and can be reached out via phone at 770-785-5910. You can also correspond with Bruce Walter Richardson through the mailing address at 4705 TREEHILLS PKWY, STONE MOUNTAIN, GA - 30088-3053 (mailing address contact number: ).

Location: 977 Taylor St Sw # A, Conyers, GA, 30088-3053
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467514471
Provider Name
Bruce Walter Richardson
Credential
Provider Entity Type
Individual
Gender
Male
Address
977 Taylor St Sw # A, Conyers, GA, 30088-3053
Phone Number
770-785-5910
Fax Number
Provider Enumeration Date
12/15/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
977 Taylor St Sw # A
City
Conyers
State
Georgia
Zip
30012-5357
Phone Number
770-785-5910
Fax Number
person
Provider Business Mailing Address Details
Address
977 Taylor St Sw # A
City
Conyers
State
Georgia
Zip
30012-5357
Phone Number
770-785-5910
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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