Organization
ATLANTA CENTER FOR FAMILY WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL ANDREW WILSON III PSY.D. (PSYCHOLOGIST)
(404) 550-9981
Entity
Organization
Contact information
Practice address
1401 PEACHTREE ST NE STE 210, ATLANTA, GA 30309-3000
(404) 550-9981
(404) 475-4880
Mailing address
PO BOX 7730, ATLANTA, GA 30357-0730
(404) 550-9981
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY002857
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624392123A
—
GA
Enumeration date
05/05/2008
Last updated
03/27/2013
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