Organization
DIANE C. SPERRY, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE C. SPERRY PH.D. (REGISTERED AGENT)
(678) 935-9567
Entity
Organization
Contact information
Practice address
10475 MEDLOCK BRIDGE RD, BUILDING 300, SUITE 315, JOHNS CREEK, GA 30097-4433
(678) 935-9567
(678) 935-9568
Mailing address
10475 MEDLOCK BRIDGE RD, BUILDING 300, SUITE 315, JOHNS CREEK, GA 30097-4433
(678) 935-9567
(678) 935-9568
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PSY003160
GA
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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