Provider Demographics
NPI:1235487992
Name:TWOHILL, PAMELA DIANE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DIANE
Last Name:TWOHILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 BETHANY CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8071
Mailing Address - Country:US
Mailing Address - Phone:404-399-0993
Mailing Address - Fax:
Practice Address - Street 1:3012 BETHANY CHURCH RD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-8071
Practice Address - Country:US
Practice Address - Phone:404-399-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0047281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical