| John Mauldin Phd Llc | |
|
2404 Refuge Rd Jasper GA 30143-4946 | |
| (706) 579-2247 | |
| Not Available |
| Full Name | John Mauldin Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2404 Refuge Rd, Jasper, Georgia |
| Authorized Official Name and Position | John Mauldin (OWNER) |
| Authorized Official Contact | 7064023525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Mauldin Phd Llc 2404 Refuge Rd Jasper GA 30143-4946 Ph: () - | John Mauldin Phd Llc 2404 Refuge Rd Jasper GA 30143-4946 Ph: (706) 579-2247 |
| NPI Number | 1154515278 |
|---|---|
| Provider Enumeration Date | 08/31/2007 |
| Last Update Date | 10/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154515278 | NPI | - | NPPES |
| 000365274B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY001342 (Georgia) | Primary |
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