Individual
LESLIE MIDDLETON WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
37 CALUMET PKWY # J, NEWNAN, GA 30263-6734
(770) 251-0530
(770) 251-8656
Mailing address
PO BOX 458, MORELAND, GA 30259-0458
(770) 251-0530
(770) 251-8656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
004018
GA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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