Individual
DR. SAMUEL JERMAINE MADDOX
Active
Individual
DR. SAMUEL JERMAINE MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002983
GA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY002983
GA
103TF0000X
Family Psychologist
PSY002983
GA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PSY002983
GA
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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