Organization
NORTH GEORGIA NEUROPSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN HUTHWAITE PSY.D. (PRESIDENT)
(678) 462-0762
Entity
Organization
Contact information
Practice address
1485 JESSE JEWEL PARKWAY SE, GAINESVILLE, GA 30501
(678) 462-0762
Mailing address
7145 LANIER COVE COURT, CUMMING, GA 30041-2198
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY002863
GA
103TC0700X
Clinical Psychologist
PSY002863
GA
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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