Individual
MARY PETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2775 CRUSE RD STE 901, LAWRENCEVILLE, GA 30044-7143
(203) 273-7063
Mailing address
2775 CRUSE RD STE 901, LAWRENCEVILLE, GA 30044-7143
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW009963
GA
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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