Pathways Unlimited, Inc | |
913 Main St Ste H Stone Mountain GA 30083-3096 | |
(770) 413-1980 | |
(770) 413-8118 |
Full Name | Pathways Unlimited, Inc |
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Speciality | Psychologist |
Location | 913 Main St Ste H, Stone Mountain, Georgia |
Authorized Official Name and Position | Monique Farr Gray (PSYCHOLOGIST) |
Authorized Official Contact | 7704131980 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pathways Unlimited, Inc 913 Main St Ste H Stone Mountain GA 30083-3096 Ph: (770) 413-1980 | Pathways Unlimited, Inc 913 Main St Ste H Stone Mountain GA 30083-3096 Ph: (770) 413-1980 |
NPI Number | 1871764282 |
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Provider Enumeration Date | 03/13/2008 |
Last Update Date | 03/13/2008 |
Medicare PECOS PAC ID | 7416106000 |
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Medicare Enrollment ID | O20120925000264 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871764282 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 2373 (Georgia) | Primary |
Provider Name | Monique F Gray |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1891865317 PECOS PAC ID: 2961651559 Enrollment ID: I20120925000299 |
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