Individual
MRS. SONDRA SHANTEL GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1000 COMMISSIONER DR, DARIEN, GA 31305-9487
(912) 437-9300
(912) 437-9481
Mailing address
1900 TEBEAU STREET, MAYO CLINIC HEALTH SYSTEM IN WAYCROSS, WAYCROSS, GA 31501
(912) 338-6338
(912) 338-6337
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW004919
GA
1041C0700X
Clinical Social Worker
MSW003847
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MSW003847
STATE LICENSE
GA
Enumeration date
06/15/2006
Last updated
06/14/2013
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