Organization
FAMILY AND CHILD DEVELOPMENT CENTER OF JOHNS CREEK LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCINDA TAYLOR GRAPENTHIN (OWNER)
(404) 433-7363
Entity
Organization
Contact information
Practice address
360 PROSPECT PL, ALPHARETTA, GA 30005-5467
(404) 433-7363
(770) 645-9281
Mailing address
500 ARGYLL CRST, ALPHARETTA, GA 30022-6118
(404) 433-7363
(770) 645-9281
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2289
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000922556A
—
GA
Enumeration date
10/16/2012
Last updated
10/16/2012
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