Individual
CONSUELA MARIA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
118 CUTTER GAP SE, LUDOWICI, GA 31316-3104
(678) 591-4474
Mailing address
118 CUTTER GAP SE, LUDOWICI, GA 31316-3104
(706) 627-4690
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW007737
GA
1041C0700X
Clinical Social Worker
Primary
CSW007317
GA
Other
Enumeration date
08/27/2018
Last updated
07/10/2023
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