Organization
GEORGIA PSYCHOLOGICAL TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYDIA ODENAT PHD (PSYCHOLOGIST)
(678) 687-9149
Entity
Organization
Contact information
Practice address
1640 POWERS FERRY RD SE, MARIETTA, GA 30067-5491
(770) 575-1696
(404) 891-6467
Mailing address
1777 WALKER RIDGE DR SW, MARIETTA, GA 30064-4192
(678) 687-9149
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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