Individual
TIMOTHY JAMES AYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
115 HABERSHAM DR, FAYETTEVILLE, GA 30214
(770) 461-9944
(770) 461-9779
Mailing address
115 HABERSHAM DR, FAYETTEVILLE, GA 30214
(770) 461-9944
(770) 461-9779
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1928
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00637788A
—
GA
Enumeration date
11/30/2006
Last updated
07/08/2007
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