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Individual

JONATHAN TODD GEORGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
2308 PERIMETER PARK DR, SUITE 100, ATLANTA, GA 30341-1316
(770) 457-5577
Mailing address
2308 PERIMETER PARK DR, SUITE 100, ATLANTA, GA 30341-1316
(770) 457-5577

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY003656
GA
103TB0200X
Cognitive & Behavioral Psychologist
PSY003656
GA
103TC0700X
Clinical Psychologist
Primary
PSY003656
GA
103TC1900X
Counseling Psychologist
PSY003656
GA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY003656
GA
103TF0000X
Family Psychologist
PSY003656
GA
103TF0200X
Forensic Psychologist
PSY003656
GA

Other

Enumeration date
03/26/2013
Last updated
03/26/2013
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