Individual
DR. LILLIE BEATRICE HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
610 KENTUCKY ST, SCOTTDALE, GA 30079-1124
(470) 672-6568
Mailing address
610 KENTUCKY ST, SCOTTDALE, GA 30079-1124
(470) 672-6568
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY003967
GA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PSY003967
GA
103TS0200X
School Psychologist
PSY003967
GA
Other
Enumeration date
04/03/2024
Last updated
10/08/2025
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