| Pavilion Psychological Services Llc | |
|
1445 Haw Creek Corners Circle East Suite 501 Cumming GA 30041 | |
| (770) 668-4248 | |
| Not Available |
| Full Name | Pavilion Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1445 Haw Creek Corners Circle East, Cumming, Georgia |
| Authorized Official Name and Position | Ashley Baker (OWNER) |
| Authorized Official Contact | 7706684248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pavilion Psychological Services Llc Po Box 4551 Suwanee GA 30024-9004 Ph: (770) 668-4248 | Pavilion Psychological Services Llc 1445 Haw Creek Corners Circle East Suite 501 Cumming GA 30041 Ph: (770) 668-4248 |
| NPI Number | 1720441454 |
|---|---|
| Provider Enumeration Date | 03/31/2016 |
| Last Update Date | 03/31/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720441454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY003511 (Georgia) | Primary |
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