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Organization
L. EMBRY COLLINS, JR., PHD, P.C.
Active
Organization
L. EMBRY COLLINS, JR., PHD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEWIS EMBRY COLLINS JR. PHD (PSYCHOLOGIST)
(770) 446-5642
Entity
Organization
Contact information
Practice address
4530 S BERKELEY LAKE RD, SUITE B, NORCROSS, GA 30071-1660
(770) 446-5642
(770) 446-5643
Mailing address
4530 S BERKELEY LAKE RD, SUITE B, NORCROSS, GA 30071-1660
(770) 446-5642
(770) 446-5643
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY 0892
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000546356C
—
GA
Enumeration date
08/17/2009
Last updated
08/17/2009
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