Organization
L. EMBRY COLLINS, JR., PHD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEWIS EMBRY COLLINS JR. PHD (PSYCHOLOGIST)
(770) 446-5642
Entity
Organization
Contact information
Practice address
4530 S BERKELEY LAKE RD, SUITE B, NORCROSS, GA 30071-1660
(770) 446-5642
(770) 446-5643
Mailing address
4530 S BERKELEY LAKE RD, SUITE B, NORCROSS, GA 30071-1660
(770) 446-5642
(770) 446-5643
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY 0892
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000546356C
—
GA
Enumeration date
08/17/2009
Last updated
08/17/2009
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