Individual
PHYLLIS J JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1345 REDMOND CIR NW, ROME, GA 30165-1307
(910) 742-9243
(888) 746-1787
Mailing address
PO BOX 538622, ATLANTA, GA 30353-8622
(910) 535-1211
(919) 746-7603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002331
GA
Other
Enumeration date
05/15/2006
Last updated
10/16/2019
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