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753 Broad St Ste 405 Augusta GA 30901-1385 | |
| (706) 951-7836 | |
| (706) 828-6616 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 753 Broad St Ste 405, Augusta, Georgia |
| Authorized Official Name and Position | Patricia Seagraves (CEO) |
| Authorized Official Contact | 7069517836 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
753 Broad St Ste 405 Augusta GA 30901-1385 Ph: (706) 951-7836 | 753 Broad St Ste 405 Augusta GA 30901-1385 Ph: (706) 951-7836 |
| NPI Number | 1326122870 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 01/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326122870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY002748 (Georgia) | Primary |
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