Organization
GERIATRIC PSYCHOLOGY AFFILIATES LLC
Active
Other names
Psychology Services Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT NORTH ED.D (OWNER)
(931) 580-8936
Entity
Organization
Contact information
Practice address
118 MAUPIN CIR, SHELBYVILLE, TN 37160-3781
(931) 580-8936
Mailing address
118 MAUPIN CIR, SHELBYVILLE, TN 37160-3781
(931) 580-8936
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548291370
—
TN
Enumeration date
10/15/2018
Last updated
10/15/2018
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