Individual
MS. DOROTHY RENE HERDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
220 UVALDA ST, WAYCROSS, GA 31501-4569
(912) 285-2487
Mailing address
409 HOLLY ST, ST SIMONS ISLAND, GA 31522-1304
(912) 634-1186
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CSW002956
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW002956
SW LICENSE
GA
01
—
SW1720
LICENSE-SOCIALWORK
FL
Enumeration date
06/19/2007
Last updated
07/08/2007
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