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Individual

MRS. PATRICIA M WITTENBORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2935 N ASHLEY ST, VALDOSTA, GA 31602-1777
(229) 247-8700
Mailing address
3941 WEATHERBY LN, VALDOSTA, GA 31602-0878
(229) 333-2354

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
17917
TX
1041C0700X
Clinical Social Worker
Primary
CSW005326
GA

Other

Enumeration date
07/13/2006
Last updated
03/30/2015
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