MR. Myron Russell Proctor, CADC, LMSW
NPI #1245875962 in La Fayette, Georgia
Provider Information
- NPI Number
- 1245875962
- Entity Type
- Individual
- Name
- MR. Myron Russell Proctor, CADC, LMSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker
- Credential
- CADC, LMSW
- Enumeration Date
- Nov 18, 2019
- Last Updated
- Aug 21, 2023
Practice Location
- Address
- 201 N MAIN ST
- City
- La Fayette
- State
- Georgia
- ZIP Code
- 30728-2419
- Phone
- (678) 590-5589
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
| Social Worker |
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