MEDICARE: DR. CASSANDRA G. LETTENBERGER-KLEIN LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	001382	GA

General Provider Information

NPI Number	:	1134518954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASSANDRA G. LETTENBERGER-KLEIN LMFT

Provider Business Mailing Address
First Line	:	260 AMBERTON CT
Second Line	:
City	:	JOHNS CREEK
State	:	GA
Zip	:	30097-1896
Country	:	US
Telephone Number	:	847-867-6955
Fax Number	:

Provider Business Practice Location Address
First Line	:	1075 ZONOLITE RD NE
Second Line	:	1A
City	:	ATLANTA
State	:	GA
Zip	:	30306-2013
Country	:	US
Telephone Number	:	404-478-9890
Fax Number	:	404-963-0975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2015
Last Update Date	:	01/16/2015

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