TEQUILLA BREW-CHANN

CANTON, GA
NPI1467209437
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: GA  CSW008717)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: TX  103578)
1041C0700X Social Worker, Clinical
(Licence: WA  LW61014204)
1041C0700X Social Worker, Clinical
(Licence: CA  LCSW95036)
Enumeration Date2024-05-06
Last Update Date2025-10-29
Business Address
TEQUILLA BREW-CHANN
133 STARGAZE RDG
CANTON, GA 30114-5149
Phone number: 999-999-9999
Mailing Address
TEQUILLA BREW-CHANN
133 STARGAZE RDG
CANTON, GA 30114-5149
Phone number: 760-475-0169