Organization
SOUTHEASTERN PSYCHOLOGICAL ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRISCILLA FAULKNER PSYD (OWNER/DIRECTOR)
(678) 712-6520
Entity
Organization
Contact information
Practice address
3155 MILL STREET, COVINGTON, GA 30014
(404) 226-0939
(678) 802-0939
Mailing address
3155 MILL STREET, COVINGTON, GA 30014-2542
(678) 712-6520
(678) 712-6521
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY002144
GA
Other
Enumeration date
12/29/2011
Last updated
05/03/2017
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