Individual
DR. AVERY JAY BEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
150 E PONCE DE LEON AVE, SUITE 255, DECATUR, GA 30030-2543
(404) 235-0132
Mailing address
150 E PONCE DE LEON AVE, SUITE 255, DECATUR, GA 30030-2543
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2040
GA
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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