Individual
FELICIA PRATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
962 JOSEPH E BOONE BLVD NW # 13, ATLANTA, GA 30314-2765
(678) 881-7695
Mailing address
962 JOSEPH E BOONE BLVD NW, ATLANTA, GA 30314-2765
(678) 881-7695
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
GA
1041S0200X
School Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
GA
172A00000X
Driver
—
GA
173000000X
Legal Medicine
—
GA
207QA0401X
Addiction Medicine (Family Medicine) Physician
1167203
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053043082
FAMILY MEDICINE
GA
Enumeration date
03/21/2021
Last updated
03/21/2021
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