Individual
GLORIA SMITH CISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMSW
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
004607
GA
104100000X
Social Worker
003871
GA
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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