Individual
MS. JANIS C RAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
300 W HOSPITAL RD, DDEAMC, FORT GORDON, GA 30905-5741
(706) 787-9186
(706) 787-3562
Mailing address
300 W HOSPITAL RD # 13A-10, DDEAMC, FORT GORDON, GA 30905-5741
(706) 787-9186
(706) 787-8991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
38409
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38409
LCSW-C
TX
Enumeration date
12/05/2006
Last updated
10/16/2013
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