Organization
KEVIN J RICHARDS, PH.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN J RICHARDS PH.D. (OWNER)
(678) 310-3442
Entity
Organization
Contact information
Practice address
199 FRASIER ST SE, MARIETTA, GA 30060-2201
(678) 310-3442
(678) 564-4401
Mailing address
199 FRASIER ST SE, MARIETTA, GA 30060-2201
(678) 310-3442
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PSY002508
GA
103TF0200X
Forensic Psychologist
Primary
PSY002508
GA
Other
Enumeration date
10/09/2007
Last updated
06/01/2011
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