Organization
SOLDIER THERAPIST
Active
Other names
The Soldier Therapist
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND EDWIN JEANES LCSW (OWNER)
(678) 805-7181
Entity
Organization
Contact information
Practice address
1760 LAKES PKWY UNIT 4416, LAWRENCEVILLE, GA 30043-6194
(678) 805-7181
Mailing address
1760 LAKES PKWY UNIT 4416, LAWRENCEVILLE, GA 30043-6194
(678) 805-7181
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/28/2021
Last updated
02/28/2022
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