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Individual

DONALD L. BLIWISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1841 CLIFTON RD NE RM 509, WESLEY WOODS HEALTH CENTER, ATLANTA, GA 30329-4021
(404) 728-4751
(404) 712-8145
Mailing address
1841 CLIFTON RD NE RM 509, WESLEY WOODS HEALTH CENTER, ATLANTA, GA 30329-4021
(404) 728-4751
(404) 712-8145

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1700
GA

Other

Enumeration date
09/04/2013
Last updated
09/04/2013
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