Individual
JACQUELINE RAYE BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1244 CLAIRMONT RD, SUITE 204, DECATUR, GA 30030-1259
(404) 493-0240
Mailing address
841 VISTA WAY, DECATUR, GA 30033-5112
(404) 298-0794
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002677
GA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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