Individual
LETERRIOUS DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2897 BATTLE FORREST DR, DECATUR, GA 30034-2756
(312) 731-3944
Mailing address
2897 BATTLE FORREST DR, DECATUR, GA 30034-2756
(404) 348-6672
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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