Bruce R Penn INC

NPI #1023255684 in Tucker, Georgia

Provider Information

NPI Number: 1023255684
Entity Type: Organization
Organization Name: Bruce R Penn INC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Jan 19, 2009
Last Updated: Jan 19, 2009

Practice Location

Address: 5165 LAVISTA RD
City: Tucker
State: Georgia
ZIP Code: 30084-3602
Phone: (770) 908-1746

Authorized Official

Name: NANCY F PENN, LCSW
Title: AUTHORIZED OFFICIAL
Phone: (770) 908-1746

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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