MR. Bruce Walter Richardson

NPI #1467514471 in Conyers, Georgia

Provider Information

NPI Number: 1467514471
Entity Type: Individual
Name: MR. Bruce Walter Richardson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: Dec 15, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 977 TAYLOR ST SW # A
City: Conyers
State: Georgia
ZIP Code: 30012-5357
Phone: (770) 785-5910

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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