Organization
THE STEVENS PSYCHOLOGY CLINIC
Active
Other names
The Stevens Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE SMITH (OFFICE MANAGER)
(706) 226-1146
Entity
Organization
Contact information
Practice address
405 S THORNTON AVE, DALTON, GA 30720-8285
(706) 226-1146
(706) 226-1483
Mailing address
405 SOUTH THORNTON AVE, DALTON, GA 30720
(706) 226-1146
(706) 226-1483
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
001895
GA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
040248
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00665871D
—
GA
05
—
00675353D
—
GA
Enumeration date
05/08/2008
Last updated
05/08/2008
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