Organization
WELLSTAR PEDIATRIC & FAMILY WELLNESS CENTER, LLC
Active
Organization
WELLSTAR PEDIATRIC & FAMILY WELLNESS CENTER, LLC
Active
Parent organization
WELLSTAR HEALTH SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR HEALTH SYSTEM
Authorized official
NICOLE ASHE (ASST; VP OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
1810 MULKEY RD, SUITE 201, AUSTELL, GA 30106-1151
(770) 634-2349
(770) 819-0597
Mailing address
1810 MULKEY RD, SUITE 201, AUSTELL, GA 30106-1151
(770) 634-2349
(770) 819-0597
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
07/07/2009
Last updated
07/07/2009
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