Organization
COMMENCEMENT ETC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SYNITA HUDGINS (OWNER/CEO)
(470) 407-3127
Entity
Organization
Contact information
Practice address
1300 RIDENOUR BLVD NW STE 100, KENNESAW, GA 30152-4528
(470) 407-3127
Mailing address
2774 COBB PKWY NW, SUITE 109, #379, KENNESAW, GA 30152
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TF0200X
Forensic Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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