Individual
MRS. CIARA JACOLE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1025 WARRENTON HWY STE A, THOMSON, GA 30824-8061
(706) 496-5929
Mailing address
225 CROWN HEIGHTS WAY, GROVETOWN, GA 30813-5906
(706) 496-5929
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MSW012953
GA
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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