Provider Demographics
NPI:1982947156
Name:PERRY GIGUERE, KIMBERLY BROOKE (LMSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BROOKE
Last Name:PERRY GIGUERE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:BROOKE
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1455 MONTREAL RD
Mailing Address - Street 2:SOCIAL SERVICES
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8100
Mailing Address - Country:US
Mailing Address - Phone:404-251-3319
Mailing Address - Fax:404-251-3097
Practice Address - Street 1:1455 MONTREAL RD
Practice Address - Street 2:SOCIAL SERVICES
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-8100
Practice Address - Country:US
Practice Address - Phone:404-251-3319
Practice Address - Fax:404-251-3097
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW004702104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker