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Individual

AMANDA MOLITERNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
2403 NOBLE CREEK DR NW, ATLANTA, GA 30327-5112
(330) 398-4162

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC012766
GA

Other

Enumeration date
10/28/2022
Last updated
10/28/2022
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