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Individual

PRISCILLA B FAULKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
3155 MILL STREET, COVINGTON, GA 30014-2542
(678) 712-6520
(678) 712-6521
Mailing address
3155 MILL STREET, COVINGTON, GA 30014-2542
(678) 712-6520
(678) 712-6521

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY002144
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000765751A
GA
Enumeration date
02/27/2007
Last updated
08/18/2015
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