Organization
WBC GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STUART KOMAN PHD (CEO/PRESIDENT)
(781) 647-6767
Entity
Organization
Contact information
Practice address
4536 BARCLAY DR, ATLANTA, GA 30338-7145
(770) 458-8711
Mailing address
51 SAWYER RD, WALTHAM, MA 02453-3448
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
12/28/2016
Last updated
05/30/2019
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