| Doctor Name: | GWENDOLYN LIGH BOHN |
| NPI Number: | 1497053946 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MT, MSW, LCSW |
| License Number: | 0904006226 |
| Business Practice Address: | 1480 Oak Bridge Ct Powhatan, VA - 231398054 |
| Business Phone Number: | 8044231389 |
| Business Fax Number: | 8044231393 |
| Mailing Address: | 2742 Flour Mill Dr, MIDLOTHIAN |
| State: | VA |
| Postal Code: | 231124265 |
| Phone Number: | 8043057091 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2011 |
| NPI Last Update Date: | 03/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904006226 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |