Organization
SWEETWATER PSYCHOLOGICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CLYDE MARTIN PH.D. (OWNER/PARTNER)
(770) 732-0982
Entity
Organization
Contact information
Practice address
2625 SANDY PLAINS RD STE 202, SECONDARY LOCATION, MARIETTA, GA 30066-4291
(770) 732-0983
(770) 732-1283
Mailing address
PO BOX 1078, LITHIA SPRINGS, GA 30122-1078
(770) 732-0982
(770) 732-1283
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY001157
GA
103TC0700X
Clinical Psychologist
Primary
PSY001373
GA
1041C0700X
Clinical Social Worker
CSW000729
GA
Other
Enumeration date
12/05/2006
Last updated
08/10/2007
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