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Organization

TARA M. BOADU, PSY.D. LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TARA M BOADU PSY.D. (PSYCHOLOGIST)
(678) 643-4495
Entity
Organization

Contact information

Practice address
4530 S BERKELEY LAKE RD, SUITE B, BERKELEY LAKE, GA 30071-1660
(470) 514-3727
(770) 446-5643
Mailing address
4530 S BERKELEY LAKE RD, SUITE B, BERKELEY LAKE, GA 30071-1660
(470) 514-3727
(770) 446-5643

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003163
GA

Other

Enumeration date
01/12/2015
Last updated
01/12/2015
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