Individual
JEANIE WITCRAFT SHIAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1007 MANSELL RD STE A107, ROSWELL, GA 30076-5019
(678) 667-1673
Mailing address
12095 CRABAPPLE LAKE DR, ROSWELL, GA 30076-4260
(678) 809-5835
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
CSW4647
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962891853
NPPES
GA
05
—
330739
—
GA
Enumeration date
03/26/2007
Last updated
06/04/2024
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