Individual
LESLIE PHILLOS DUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
208 RIVER PARK NORTH DR, WOODSTOCK, GA 30188-7834
(404) 307-9071
Mailing address
6750 POLO DR, CUMMING, GA 30040-5725
(404) 403-5690
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC010687
GA
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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