Individual
BRANDY MOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3002 RIDGE AVE, MACON, GA 31204-2404
(603) 703-7664
Mailing address
3002 RIDGE AVE, MACON, GA 31204-2404
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006519
GA
Other
Enumeration date
08/16/2018
Last updated
12/29/2021
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