Individual
DR. JOVANNA OMARI WILSON GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3278 MITCHELL BLVD, MOODY AFB, GA 31699
(910) 394-4700
(910) 394-4711
Mailing address
3278 MITCHELL BLVD, MOODY AFB, GA 31699
(910) 425-4443
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
070002
NY
1041C0700X
Clinical Social Worker
070002-1
NY
1041C0700X
Clinical Social Worker
7893
OK
Other
Enumeration date
12/01/2005
Last updated
08/28/2023
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