Individual
MRS. SHANA GISSENTANNER CONLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2760 PEACHTREE INDUSTRIAL BLVD STE C, DULUTH, GA 30097-2201
(404) 919-0917
Mailing address
4150 EDEN VALLEY DR, LOGANVILLE, GA 30052-7551
(678) 851-9177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW009015
GA
Other
Enumeration date
06/27/2023
Last updated
03/25/2024
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