Organization
FAMILY 360 INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DESMOND ORVILLE MAUL (OWNER)
(770) 679-0586
Entity
Organization
Contact information
Practice address
2215 EXCHANGE PL SE STE A, CONYERS, GA 30013-6723
(770) 679-0586
(770) 554-9349
Mailing address
2215 EXCHANGE PL SE STE A, CONYERS, GA 30013-6723
(770) 679-0586
(770) 285-6325
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT 001191
GA
Other
Enumeration date
02/25/2011
Last updated
02/07/2024
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