Individual
KELLY LUCE ACEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 PETROL PT, SUITE H, PEACHTREE CITY, GA 30269-1550
(470) 296-1841
Mailing address
117 HOLLY SPRINGS DR, PEACHTREE CITY, GA 30269-3045
(470) 296-1841
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW005370
GA
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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