Organization
ACADEMY PSYCHOLOGICAL SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEVORAH A GIFFEN PSY (PSYCHOLOGIST)
(404) 558-9830
Entity
Organization
Contact information
Practice address
5165 LAVISTA RD, TUCKER, GA 30084-3602
(404) 558-9830
(770) 939-6781
Mailing address
5165 LAVISTA RD, TUCKER, GA 30084-3602
(404) 558-9830
(770) 939-6781
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY001764
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000584526A
—
GA
Enumeration date
08/03/2010
Last updated
08/03/2010
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