Organization
JOHN MAULDIN PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MAULDIN JR. PH.D. (OWNER)
(706) 402-3525
Entity
Organization
Contact information
Practice address
2404 REFUGE RD, JASPER, GA 30143-4946
(706) 579-2247
Mailing address
2404 REFUGE RD, JASPER, GA 30143-4946
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY001342
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000365274B
—
GA
Enumeration date
08/31/2007
Last updated
10/15/2010
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