Organization
TEWANN TEPPER LPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TISA MACKLIN (ENROLLMENT SPECIALIST)
(404) 827-8038
Entity
Organization
Contact information
Practice address
1755 THE EXCHANGE SE, ATLANTA, GA 30339-7400
(770) 401-4339
Mailing address
5701 RUTLAND CIR, POWDER SPRINGS, GA 30127-4776
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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