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Organization

SAMUDRA PSYCHOLOGICAL SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELIZABETH SUE BRADSHAW-LIVINGSTON PHD (LICENSED PSYCHOLOGIST)
(404) 249-0520
Entity
Organization

Contact information

Practice address
675 SEMINOLE AVE NE STE T03, ATLANTA, GA 30307-3409
(404) 249-0520
Mailing address
316 SOMERLANE PL, AVONDALE ESTATES, GA 30002-1221
(269) 352-7407

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
003691
GA

Other

Enumeration date
07/24/2018
Last updated
07/24/2018
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