Organization
ASHLEY N. PETTONI, PSY.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHLEY N PETTONI PSY. D (PSYCHOLOGIST)
(404) 550-0388
Entity
Organization
Contact information
Practice address
485 HUNTINGTON RD, 201, ATHENS, GA 30606-1861
(706) 546-8440
Mailing address
2625 PIEDMONT RD NE, 56-298, ATLANTA, GA 30324-3086
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY003250
GA
103TC0700X
Clinical Psychologist
PSY003250
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364591572A
—
GA
05
—
364591572B
—
GA
Enumeration date
10/05/2009
Last updated
10/05/2009
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