Individual
BENAJAH MARION
Active
Individual
BENAJAH MARION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LMFT
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW000901
GA
106H00000X
Marriage & Family Therapist
MFT 000497
GA
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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