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Individual

PANYA RENEE NASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
670 ESCALADE DR, COLLEGE PARK, GA 30349-2508
(706) 536-9523

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW003736
GA
1041C0700X
Clinical Social Worker
Primary
CSW003917
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251S0000X
GA
Enumeration date
06/18/2007
Last updated
10/18/2010
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