Organization
DIVINE PSYCHOLOGY, LLC
Active
Organization
DIVINE PSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARA VELEZ PSYD (CLINICAL PSYCHOLOGIST & OWNER)
(678) 626-7207
Entity
Organization
Contact information
Practice address
4343 SHALLOWFORD RD STE G3, MARIETTA, GA 30062-5021
(678) 626-7207
Mailing address
2960 SILVERPLUME DR, FORT COLLINS, CO 80526-2488
(678) 626-7207
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
PSY003469
GA
103TC0700X
Clinical Psychologist
Primary
PSY003469
GA
103TH0004X
Health Psychologist
PSY003469
GA
103TR0400X
Rehabilitation Psychologist
PSY003469
GA
Other
Enumeration date
12/01/2017
Last updated
05/28/2021
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