Organization
GRACE PSYCHOTHERAPY & PSYCHOLOGICAL ASSESMENT SERVICES OF NORTH GA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN F GRACE PSY,D. (OWNER)
(706) 552-0450
Entity
Organization
Contact information
Practice address
1 HUNTINGTON RD, SUITE 801, ATHENS, GA 30606-7204
(706) 552-0450
(706) 850-7211
Mailing address
1 HUNTINGTON RD, SUITE 801, ATHENS, GA 30606-7204
(706) 552-0450
(706) 850-7211
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003032
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
476047042A
—
GA
Enumeration date
08/14/2012
Last updated
11/05/2012
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