Individual
LESLIE DANNENE PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E TRINITY PL, DECATUR, GA 30030-3302
(404) 200-7790
Mailing address
11901 LOVEJOY CROSSING BLVD, HAMPTON, GA 30228-5982
(404) 200-7790
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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