Individual
MR. QUENTIN TYRON PATRICK SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
209 VILLA GRANDE DR, LOCUST GROVE, GA 30248-7110
(470) 620-0197
Mailing address
209 VILLA GRANDE DR, LOCUST GROVE, GA 30248-7110
(470) 620-0197
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW012411
GA
Other
Enumeration date
08/19/2025
Last updated
08/20/2025
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