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Organization

NORTH GEORGIA PSYCHOLOGICAL CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FRED FRASER PH.D (PRESIDENT)
(678) 992-0089
Entity
Organization

Contact information

Practice address
11755 POINTE PL STE B, ROSWELL, GA 30076-4656
(678) 992-0089
Mailing address
11755 POINTE PL STE B, ROSWELL, GA 30076-4656
(678) 992-0089

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1522
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1522
LICENSED PSYCHOLOGIST
GA
01
2282
LICENSED PROFESSIONAL COUNSELOR
GA
Enumeration date
12/21/2009
Last updated
12/21/2009
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