Provider Demographics
NPI:1245525286
Name:GIRARDEAU, BOBBIE (LCSW)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:
Last Name:GIRARDEAU
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 1:5700 FERNSIDE DR
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-8942
Mailing Address - Country:US
Mailing Address - Phone:706-282-4542
Mailing Address - Fax:706-282-4544
Practice Address - Street 1:4331 THURMOND TANNER PKWY
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-2829
Practice Address - Country:US
Practice Address - Phone:678-513-5700
Practice Address - Fax:678-513-5836
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0019881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical