Individual
RAQUEL VANESSA GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW CP, LMSW
Contact information
Practice address
1061 HARMON AVE, BUILDING 311, FORT STEWART, GA 31314-5641
(912) 435-6779
Mailing address
1061 HARMON AVE, BUILDING 311, FORT STEWART, GA 31314-5641
(912) 435-6779
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
069473
NY
104100000X
Social Worker
MSW004199
GA
1041C0700X
Clinical Social Worker
Primary
8817
SC
Other
Enumeration date
10/03/2006
Last updated
03/23/2010
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