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Individual

MRS. MARLENE FRANCES PETTA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MSSA ACSW LMSW

Contact information

Practice address
380 CROWN MILL DR, MARTINEZ, GA 30907-9436
(706) 364-7954
(706) 364-7954
Mailing address
380 CROWN MILL DR, MARTINEZ, GA 30907-9436
(706) 364-7954
(706) 364-7954

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
L760944
MI
1041C0700X
Clinical Social Worker
Primary
L760944
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2152167
CIGNA
Enumeration date
02/17/2006
Last updated
09/11/2025
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