Individual
JESSICA LYNN CONANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 GOLDEN POND RD, VIDALIA, GA 30474-9679
(401) 862-7443
Mailing address
450 GOLDEN POND RD, VIDALIA, GA 30474-9679
(401) 862-7443
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
117962
MA
1041C0700X
Clinical Social Worker
11962
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/24/2011
Last updated
06/19/2024
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