Individual
MRS. LESLIE PATE MACKINNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LESLIE MACKINNON
Contact information
Practice address
1836 WALTHALL DR NW, ATLANTA, GA 30318-2647
(404) 603-5335
Mailing address
1836 WALTHALL DR NW, ATLANTA, GA 30318-2647
(404) 355-3887
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000817
GA
Other
Enumeration date
07/31/2013
Last updated
12/03/2014
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