Organization
DIANE C. SPERRY, PH.D., LLC
Active
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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