Organization
POWELL PSYCHOLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES POWELL PH.D. (OWNER)
(404) 403-6177
Entity
Organization
Contact information
Practice address
2501 E PIEDMONT RD, SUITE 200, PMB 5, MARIETTA, GA 30062-7752
(404) 403-6177
(404) 393-6460
Mailing address
2501 E PIEDMONT RD, SUITE 200, PMB 5, MARIETTA, GA 30062-7752
(404) 403-6177
(404) 393-6460
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002212
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000480686A
—
GA
Enumeration date
10/25/2012
Last updated
10/25/2012
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