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General NPI Number Information
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NPI Number | 1558823955
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Entity Type | Organization
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Legal Business Name | SUSAN E TUTTY LLC
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Dates
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Enumeration Date | 04/03/2019
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 1842 INDEPENDENCE SQ STE D
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City | DUNWOODY
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State | GA
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Zip | 30338-5168
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Country | US
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Telephone | 678-982-6189
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Fax | 404-393-8389
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Provider Business Mailing Address
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Address Line | 1842 INDEPENDENCE SQ STE D
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City | DUNWOODY
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State | GA
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Zip | 30338-5168
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Country | US
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Telephone | 678-982-6189
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Fax | 404-393-8389
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Authorized Official
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Title or Position | OWNER-PSYCHOTHERAPIST
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Name | SUSAN E TUTTY
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Credential | LCSW
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Telephone | 678-982-6189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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