Individual
JEREMY CADE SHIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1651 PHOENIX BLVD, SUITE 2, COLLEGE PARK, GA 30349-5552
(770) 997-1738
(770) 991-1375
Mailing address
1651 PHOENIX BLVD, SUITE 2, COLLEGE PARK, GA 30349-5552
(770) 997-1738
(770) 991-1375
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003936
GA
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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