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6576 Church St Douglasville GA 30134-1884 | |
| (770) 577-7873 | |
| (770) 577-7871 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 6576 Church St, Douglasville, Georgia |
| Authorized Official Name and Position | Felicia Berry-mitchell (PRESIDENT) |
| Authorized Official Contact | 7705777873 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6576 Church St Douglasville GA 30134-1884 Ph: (770) 577-7873 | 6576 Church St Douglasville GA 30134-1884 Ph: (770) 577-7873 |
| NPI Number | 1215357272 |
|---|---|
| Provider Enumeration Date | 04/17/2014 |
| Last Update Date | 04/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215357272 | NPI | - | NPPES |
| 003132073B | Medicaid | GA |
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