| NPI | 1235338369 |
|---|---|
| Other Name | GEORGIA CAROL SOUTHARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000000714) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000135558) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |