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Individual

DR. MARK MANFRED ROLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
21 TRAMMEL ST. SW, PSYCHOLOGICAL CONSULTANTS OF MARIETTA PC, MARIETTA, GA 30064-3249
(770) 420-9448
(770) 420-9441
Mailing address
PO BOX 515, PSYCHOLOGICAL CONSULTANTS OF MARIETTA PC, MARIETTA, GA 30061-0515
(770) 420-9448
(770) 420-9441

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1872
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00661691A
GA
Enumeration date
02/16/2007
Last updated
09/16/2008
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