Organization
MAUVESCAPE LLC
Active
Other names
Mauvescape
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANTEA D WILLIAMS PH.D. (OWNER)
(678) 701-9559
Entity
Organization
Contact information
Practice address
675 SEMINOLE AVE NE STE 307, ATLANTA, GA 30307-3416
(678) 701-9559
Mailing address
675 SEMINOLE AVE NE STE 307, ATLANTA, GA 30307-3416
(678) 701-9559
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003998
GA
Other
Enumeration date
08/14/2014
Last updated
03/31/2016
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