Individual
DR. MICHAEL BUCOVETSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
4045 ORCHARD RD SE, SUITE 110, SMYRNA, GA 30080-4902
(770) 293-1950
(770) 293-1955
Mailing address
4045 ORCHARD RD SE, SUITE 110, SMYRNA, GA 30080-4902
(770) 293-1950
(770) 293-1955
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003351
GA
Other
Enumeration date
02/22/2010
Last updated
04/08/2013
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