Individual
MS. LESLIE SUTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 APPLEWOOD, DALTON, GA 30720-2699
(706) 270-5033
Mailing address
1401 APPLEWOOD DR, DALTON, GA 30720-2699
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
251S00000X
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58-2103386
HIGHLAND RIVERS CSB
—
Enumeration date
01/26/2016
Last updated
01/26/2016
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