Tushman, Dale Myra
Tushman, Dale Myra is an sole proprietor health care provider with primary practice located at 100 Mariners Dr Ste D , Kingsland GA 31548-6667. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Tushman, Dale Myra can be contacted via phone (912) 510-0669.Contact Information
Primary practice address
100 Mariners Dr Ste D
Kingsland GA 31548-6667
Phone: (912) 510-0669
Fax: (912) 510-0754
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW 001945 | Georgia |
Profile Details
| NPI number | 1013960004 |
|---|---|
| LBN Legal business name | Tushman, Dale Myra |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2006 |
| Last updated | Dec 31st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013960004 | NPPES |
| Georgia | MEDICAID | 003219987A |
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