Doctor Name: | MRS. OLGA V. JANTZER |
NPI Number: | 1073758819 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | SW3967 |
Business Practice Address: | 3580 Cameron Pkwy Stockbridge, GA - 302817816 |
Business Phone Number: | 6785656228 |
Business Fax Number: | |
Mailing Address: | 450 Ridgemont Dr, FAYETTEVILLE |
State: | GA |
Postal Code: | 302157709 |
Phone Number: | 7707161805 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2008 |
NPI Last Update Date: | 12/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW3967 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |