Dale Myra Tushman, LCSW
Social Worker, Clinical in Kingsland, GA. Individual provider (NPI-1).
NPI number1013960004
StatusActive
Last updated in NPPESDec 31, 2019
Details
- NPI
- 1013960004
- Entity type
- Individual (NPI-1)
- Name
- Dale Myra Tushman
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 18, 2006
- Certification date
- Dec 31, 2019
- Last updated
- Dec 31, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | CSW 001945 | GA | Yes |
Practice location
100 Mariners Dr Ste DKingsland, GA 31548-6667
Phone 912-510-0669 · Fax 912-510-0754
Mailing address
100 Mariners Dr Ste DKingsland, GA 31548-6667
Phone 912-510-0669 · Fax 912-510-0754
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