| Buddington Psychology Clinic, Pc | |
|
4485 Tench Rd Suite 840 Suwanee GA 30024-6741 | |
| (770) 493-9177 | |
| (770) 945-7214 |
| Full Name | Buddington Psychology Clinic, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 4485 Tench Rd, Suwanee, Georgia |
| Authorized Official Name and Position | Roger W. Buddington (PRESIDENT) |
| Authorized Official Contact | 7704939177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buddington Psychology Clinic, Pc 4485 Tench Rd Suite 840 Suwanee GA 30024-6741 Ph: (770) 493-9177 | Buddington Psychology Clinic, Pc 4485 Tench Rd Suite 840 Suwanee GA 30024-6741 Ph: (770) 493-9177 |
| NPI Number | 1366626970 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 12/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366626970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY001926 (Georgia) | Primary |
| 1041C0700X | Social Worker - Clinical | CSW003357 (Georgia) | Secondary |
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