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Organization
MICGRA TELEHEALTH LLLP
Active
Organization
MICGRA TELEHEALTH LLLP
Active
Parent organization
MICGRA TELEHEALTH LLLP
Other names
Micgra Psych LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICGRA TELEHEALTH LLLP
Authorized official
ODETTE AMANDA BUTLER NP (OWNER)
(404) 751-3700
Entity
Organization
Contact information
Practice address
301 WHITE INGRAM PKWY STE C, DALLAS, GA 30132-5066
(404) 751-3700
Mailing address
301 W I PKWY STE C, DALLAS, GA 30132-5066
(800) 867-1024
(206) 485-4710
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
Other
Enumeration date
01/30/2020
Last updated
02/04/2026
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