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Individual

MRS. RUTUBULA PETTAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1046 RIDGE AVE SW, ATLANTA, GA 30315-1640
(404) 564-6942
Mailing address
2238 NANTUCKET CT NE, MARIETTA, GA 30066-2128
(904) 610-2534

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006936
GA

Other

Enumeration date
03/20/2020
Last updated
03/20/2020
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