Individual
PATRICE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5481 TUNBRIDGE WELLS RD, LITHONIA, GA 30058-5684
(678) 460-0345
(678) 460-0350
Mailing address
5481 TUNBRIDGE WELLS RD, LITHONIA, GA 30058-5684
(678) 460-0345
(678) 460-0350
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW001836
GA
Other
Enumeration date
07/05/2011
Last updated
07/05/2011
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