Individual
KELLY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1777 NORTHEAST EXPY NE, BROOKHAVEN, GA 30329-2480
(404) 785-8200
Mailing address
1777 NORTHEAST EXPY NE, BROOKHAVEN, GA 30329-2480
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
10/18/2024
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