Individual
ANN PETESCH HAZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
35 JESSE HILL JR DR SE, ATLANTA, GA 30303-3032
(404) 616-4390
(404) 616-6795
Mailing address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 616-4875
(404) 616-6657
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
000803
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00259421
—
GA
Enumeration date
08/06/2006
Last updated
07/08/2007
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