Organization
BUDDINGTON PSYCHOLOGY CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER W. BUDDINGTON PH.D. (PRESIDENT)
(770) 493-9177
Entity
Organization
Contact information
Practice address
4485 TENCH RD, SUITE 840, SUWANEE, GA 30024-6741
(770) 493-9177
(770) 945-7214
Mailing address
4485 TENCH RD, SUITE 840, SUWANEE, GA 30024-6741
(770) 493-9177
(770) 945-7214
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY001926
GA
1041C0700X
Clinical Social Worker
CSW003357
GA
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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