| Doctor Name: | MRS. GWENDOLYN SPANN SHORTER |
| NPI Number: | 1780915983 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW, CP |
| License Number: | 9089 |
| Business Practice Address: | 430 Albert St 410 Cedar Ln. Bishopville, SC - 290101202 |
| Business Phone Number: | 4438571248 |
| Business Fax Number: | 8038431410 |
| Mailing Address: | 430 Albert St, Po Box 282 BISHOPVILLE |
| State: | SC |
| Postal Code: | 290101202 |
| Phone Number: | 4438571248 |
| Fax Number: | 8034831410 |
| NPI Enumeration Date: | 01/27/2010 |
| NPI Last Update Date: | 01/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 9089 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |