Organization
PSYCHOLOGICAL SCIENCES INST P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA BOSWELL (BUSINESS MANAGER)
(770) 813-0404
Entity
Organization
Contact information
Practice address
5955 STATE BRIDGE RD STE 110, DULUTH, GA 30097-8228
(770) 813-0404
(770) 232-9043
Mailing address
6015 STATE BRIDGE RD APT 12206, DULUTH, GA 30097-8225
(770) 813-0404
(770) 232-9043
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1464
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000609034B
—
GA
Enumeration date
09/23/2009
Last updated
09/23/2009
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