CLYTE LYDIA PORTIS

FORT GORDON, GA
NPI1447423157
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: GA  CSW003792)
Additional Taxonomies104100000X Social Worker
(Licence: GA  CSW003792)
1041S0200X Social Worker, School
(Licence: GA  CSW003792)
Enumeration Date2008-04-02
Last Update Date2013-10-29
Business Address
Mrs. CLYTE LYDIA PORTIS LCSW, LISW-CP
254 41ST ST BLDG 40709
FORT GORDON, GA 30905-5918
Phone number: 707-787-1595
Mailing Address
Mrs. CLYTE LYDIA PORTIS LCSW, LISW-CP
254 41ST ST BLDG 40709
FORT GORDON, GA 30905-5918
Phone number: 707-787-1595