Individual
DR. RAY JOSEPH KUCKLEBURG JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1780 CENTURY BLVD NE STE A, ATLANTA, GA 30345-3399
(404) 636-6607
(404) 315-9744
Mailing address
1780 CENTURY BLVD NE STE A, ATLANTA, GA 30345-3399
(404) 636-6607
(404) 315-9744
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
414
GA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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