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Individual

MRS. KASHANA TANESHIA GAINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
30 HOULTON ST, PATTEN, ME 04765-3035
(207) 538-3700
Mailing address
6407 SWALLOWTAIL DR, STATESBORO, GA 30461-0724
(912) 362-5267

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW005733
GA
1041C0700X
Clinical Social Worker
Primary
LC22072
ME

Other

Enumeration date
05/04/2016
Last updated
03/01/2023
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