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Individual

MARYBETH ANN PETERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW CEAP

Contact information

Practice address
1457 CLAIRMONT RD, DECATUR, GA 30033-5362
(404) 272-2013
Mailing address
1457 CLAIRMONT RD, DECATUR, GA 30033-5362
(404) 272-2013

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003012
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14322245
CAQH
GA
Enumeration date
10/07/2019
Last updated
10/07/2019
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