Doctor Name: | MS. SUSAN PETERSON-HAZAN |
NPI Number: | 1003163981 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CSW |
License Number: | CSW001190 |
Business Practice Address: | 1821 Clifton Rd Ne Atlanta, GA - 303294021 |
Business Phone Number: | 4047286273 |
Business Fax Number: | 4047286577 |
Mailing Address: | 1821 Clifton Rd Ne, ATLANTA |
State: | GA |
Postal Code: | 303294021 |
Phone Number: | 4047286273 |
Fax Number: | 4047286577 |
NPI Enumeration Date: | 08/09/2012 |
NPI Last Update Date: | 08/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CSW001190 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |