Individual
MRS. MISTY BLUE KIRKLAND NASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
408 SHIRLEY AVE, DOUGLAS, GA 31533-2002
(912) 292-1177
Mailing address
204 BAYMEADOWS DR W, DOUGLAS, GA 31535-6702
(912) 381-4133
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW005752
GA
1041C0700X
Clinical Social Worker
Primary
CSW008238
GA
Other
Enumeration date
02/10/2021
Last updated
04/20/2023
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