Basic Information
| Provider Information | |||||||||
| NPI: | 1508120353 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTINI-JAMES | ||||||||
| FirstName: | GIANNA | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 856 GOLF CREST DR | ||||||||
| Address2: | |||||||||
| City: | ACWORTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301015960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706395568 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4255 WADE GREEN RD NW | ||||||||
| Address2: | SUITE414 | ||||||||
| City: | KENNESAW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301441762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782132194 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2012 | ||||||||
| LastUpdateDate: | 06/26/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CSW003164 | GA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.