Individual
MRS. JENNIFER WALKER PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT-BC, NMT
Contact information
Practice address
2180 RIDGE RD, CANTON, GA 30114-4187
(678) 231-6692
Mailing address
PO BOX 5121, CANTON, GA 30114-0033
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
07335
GA
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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