Individual
MARC W. EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1227 ALICE ST, WAYCROSS, GA 31501-4524
(912) 283-6629
(912) 283-5980
Mailing address
1227 ALICE ST, WAYCROSS, GA 31501-4524
(912) 283-6629
(912) 283-5980
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY000673
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000212726C
—
GA
Enumeration date
06/02/2006
Last updated
04/01/2019
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